ABSTRACT
Aim: Fracture-related femoral neck displacement is more likely in patients with schizophrenia because of delayed diagnosis, as these patients frequently have less severe fracture-associated subjective symptoms. This study aimed to investigate the association of schizophrenia with the risk of fracture-related femoral neck displacement in hospitalized patients. Methods: We retrospectively analyzed the medical records of patients with femoral neck fractures treated between April 2013 and March 2018 at a single institution. Multivariate logistic regression was used to explore the relationship between schizophrenia and fracture-related femoral neck displacement after adjusting for risk factors. Results: We compared 30 and 194 patients with and without schizophrenia, respectively. The prevalence of fracture-related displacement was 80.0% in patients with schizophrenia and 62.4% in the controls (p = 0.06). After adjusting for confounding variables, schizophrenia significantly correlated with fracture-related femoral neck displacement (odds ratio: 4.74, 95% confidence interval: 1.09-20.60, p = 0.0378). Conclusions: Schizophrenia is associated with a higher risk of severe femoral neck fracture. To improve outcomes and alleviate the societal burden of femoral neck fractures, early radiographic assessment and surgical intervention for femoral fractures are essential for patients with schizophrenia, even in those without pain symptoms.
ABSTRACT
BACKGROUND: Complex regional pain syndrome (CRPS) is one of the serious complications after surgical treatment of a rotator cuff tear. Both a measurement of body surface temperature and bone scintigraphy have been used as diagnostic tools for the early phase of CRPS.Unfortunately, few studies have been carried out that applied these methods to the patients after rotator cuff repair. PURPOSES: To clarify both shoulder surface temperature and bone scintigraphy findings in patients with rotator cuff tears. SUBJECTS AND METHODS: Subjects comprised patients with unilateral rotator cuff tears (five men and five women, mean age 61 years). For measurements of shoulder surface temperature, a Thermochron was attached to both shoulders. As for bone scintigraphy, intravenous injection of technetium-labelled hydroxymethylenebisphosphonic acid (99mTc-HMDP)was performed, and then images were taken with a gamma camera. RESULTS: During the measurements, the changes in body surface temperature for the affected and healthy shoulders remained within the standard deviation of the reference group. The intensity of radioisotope (RI) uptake for the affected shoulder joint was significantly increased compared to that for the healthy shoulder joint (P < 0.05). CONCLUSION: RI uptake is increased in shoulders with rotator cuff tears, whereas shoulder surface temperature shows no differences on the affected and unaffected sides.
