Fractures in myelomeningocele.
Date
2010-09
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
Abstract
BACKGROUND: In patients with myelomeningocele (MMC), a high number of fractures occur in the paralyzed extremities, affecting mobility and independence. The aims of this retrospective cross-sectional study are to determine the frequency of fractures in our patient cohort and to identify trends and risk factors relevant for such fractures. MATERIALS AND METHODS: Between March 1988 and June 2005, 862 patients with MMC were treated at our hospital. The medical records, surgery reports, and X-rays from these patients were evaluated. RESULTS: During the study period, 11% of the patients (n = 92) suffered one or more fractures. Risk analysis showed that patients with MMC and thoracic-level paralysis had a sixfold higher risk of fracture compared with those with sacral-level paralysis. Femoral-neck z-scores measured by dual-energy X-ray absorptiometry (DEXA) differed significantly according to the level of neurological impairment, with lower z-scores in children with a higher level of lesion. Furthermore, the rate of epiphyseal separation increased noticeably after cast immobilization. Mainly patients who could walk relatively well were affected. CONCLUSIONS: Patients with thoracic-level paralysis represent a group with high fracture risk. According to these results, fracture and epiphyseal injury in patients with MMC should be treated by plaster immobilization. The duration of immobilization should be kept to a minimum (<4 weeks) because of increased risk of secondary fractures. Alternatively, patients with refractures can be treated by surgery, when nonoperative treatment has failed.
Type
Department
Description
Provenance
Subjects
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Akbar, Michael, Bjoern Bresch, Patric Raiss, Carl Hans Fürstenberg, Thomas Bruckner, Thorsten Seyler, Claus Carstens, Rainer Abel, et al. (2010). Fractures in myelomeningocele. J Orthop Traumatol, 11(3). pp. 175–182. 10.1007/s10195-010-0102-2 Retrieved from https://hdl.handle.net/10161/10374.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke
Thorsten Markus Seyler
Based on a recent market research survey, the U.S. demand for implantable medical devices is forecast to increase 7.7% annually to $52 billion in 2015. While orthopedic implants remain the largest segment, implantable devices are frequently used in urology, cardiovascular specialties, neurology, gynecology, and otolaryngology. With the increased usage of implantable devices, the number of biofilm-associated infections has emerged as a significant clinical problem because biofilms are often resistant to traditional antimicrobial therapy and difficult to eradicate. In fact, biofilm cells show as much as a 1000-fold more resistance to traditional antimicrobial therapy than their planktonic cell counterparts and biofilm-based microbial infections make up to 80% of all infections in patients, leading the CDC to declare biofilms to be one of the most important medical hurdles of the century.
Since microbial biofilms are a major clinical concern, my lab seeks to (a) advance the ability to diagnose biofilm-associated infections, (b) understanding of the formation of biofilms, and (c) develop/use novel treatment approaches to prevent and treat biofilm-associated infections.
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.