Survival Analysis of Conservative Treatement in Osteoporotic Vertebral Fracture

STUDY DESIGN: Prospective study. OBJECTIVES: To define the prognostic factors by analyzing the survival rates of osteoporotic vertebral fracture treated by conservative management. SUMMARY OF THE LITERATURE REVIEW: Due to an increasing elder population, many recent studies of osteoporosis have been done; pointing out that osteoporotic vertebral fracture may produce serious complications. However, there is nothing obviously demonstrated in both the management and prognosis of the osteoporotic vertebral fracture. MATERIALS AND METHODS: Survival analysis was done for 130 patients who had undergone conservative management for a single level vertebral fracture. Univariant and multivariant survival analysis was done for age at trauma, sex, body mass index (BMI), bone mineral density (BMD), smoking, diabetic history, fracture level, fracture type, vertebral compression ratio and regional Cobb's angle. RESULTS: Survival rate for conservative management was 70.7%. Univariant analysis for survival rate revealed significantly inferior results for age over 78 (p=0.008), T score< -3.5 (p=0.047), and crush or biconcave type than wedge type (p=0.021). Only the age factor showed significance in multivariant analysis (p=0.025, Hazard ratio=2.08). CONCLUSION: Conservative management in a single level osteoporotic vertebral fracture, showed a survival rate of 70.7% and age was the most important factor in conservative management. We should notice that age of more than 78 years is at high risk for failure in conservative management of vertebral fracture.

Open Reduction of a Dislocation of the Interphalangeal Joint of the Great Toe Neglected for 6 Weeks / 대한정형외과학회잡지

Dislocation of the interphalangeal joint of the great toe is a condition which is reported rarely. Especially, it is extremely rarely reported as for the case of neglected dislocation. Here, we report one case of neglected dislocation for 6 weeks of the interphalangeal joint of the great toe. Reduction followed by a push of the incarcerated sesamoid bone based on dorsal approach, was done successfully, and we found satisfactory results after a 4 years of follow-up.