Preview

The Clinician

Advanced search

A MULTIDISCIPLINARY APPROACH IN THE TREATMENT OF FRACTURES OF THE PROXIMAL FEMUR ON THE BACKGROUND OF SENILE OSTEOPOROSIS

https://doi.org/10.17650/1818-8338-2016-10-2-18-24

Abstract

The article presents a review of published data on the problem of osteoporosis in patients older than 75 years who have had fractures of the proximal femur. We used descriptive and analytical methods. Search publications have done in accessible to free search databases. Based on our analysis, it was found: the majority of researchers in Russia and abroad are united in the opinion that this issue requires a multidisciplinary approach; surgical treatment should be initiated as early as possible after the onset of fracture, before the complications from side of the internal organs; patients with fractures on the background of senile osteoporosis should receive drugs that affect to the quantitative and qualitative components of bone.

About the Authors

N. V. Zagorodniy
State Budgetary Educational Institution of Higher Professional Education “Pirogov Russian National Research Medical University” of the Ministry of Health of Russia; Federal State Autonomous Educational Institution of Higher Education “Peoples' Friendship University of Russia”; Federal State Budgetary Educational Institution of Higher Professional Education “Moscow State University named after M.V. Lomonosov”; State Health Care Institution of Moscow City “City Clinical Hospital No. 31” Department of Health Moscow
Russian Federation

1 Ostrovityanova St., Moscow, 117997;

6 Mikluho-Maclay St., Moscow, 117198;

1 Leninskiye Gory, Moscow, 119991;

Clinic of Traumatology and Orthopedics, 1/1 Velozavodskaya St., Moscow, 115280



A. A. Volna
Federal State Autonomous Educational Institution of Higher Education “Peoples' Friendship University of Russia”; Open joint-stock company “K + 31 Clinic”
Russian Federation

6 Mikluho-Maclay St., Moscow, 117198;

42 build. 4, Lobachevskogo St., Moscow, 119415



I. I. Panfilov
Federal State Autonomous Educational Institution of Higher Education “Peoples' Friendship University of Russia”
Russian Federation
6 Mikluho-Maclay St., Moscow, 117198


References

1. Беневоленская Л.И. Проблема остеопороза в современной медицине. Научно-практическая ревматология 2005;(1):4–7. [Benevolenskaya L.I. Osteoporosis problem in the modern medicine. Nauchnaya i prakticheskaya revmatologiya = Scientific & Practical Rheumatology 2005;(1):4–7. (In Russ.)].

2. Мануленко В.В., Шишкин А.Н., Мазуренко С.О. Клинические особенности развития остеопатии у больных сахарным диабетом 2-го типа. Вестник Санкт-Петербургского университета 2009;(2):3–14. [Маnulenkо V.V., Shishkin А.N., Маzurenkо S.О. Clinical peculiarities o f the osteopathy development at patients with the 2nd type of diabetes mellitus. Vestnik SanktPeterburgskogo universiteta = Saint-Petersburg University Herald 2009;(2):3–14. (In Russ.)].

3. Шостак Н.А. Остеопороз: современные аспекты диагностики и лечения. Лечащий врач 2004;(7):26–9. [Shostak N.А. Оsteoporosis: modern aspects of the diagnostics and treatment. Lechashchiy vrach = Assistant Physician 2004;(7):26–9. (In Russ.)].

4. Насонова В.А., Бунчук Н.В. Ревматические болезни. М.: Медицина, 1997. [Nasonovа V.А., Bunchuk N.V. Rheumatic diseases. М.: Meditsina, 1997. (In Russ.)].

5. Суслов Е.И. Роль возрастных изменений сосудов и атеросклероза в генезе остеопороза. Морфология 1975;(2):154–7. [Suslov Е.I. The role of age changes of vessels and atherosclerosis in the osteoporosis genesis. Morfologiya = Morphology 1975;(2):154–7. (In Russ.)].

6. Leslie W.D., O’Donnell S., Jean S. et al. Trends in hip fracture rates in Canada. JAMA 2009;302(8):883–9.

7. Строчкова Ю.О., Лаптев В.Я., Горбунов Н.А. Применение цифровой малодозной рентгенографии для диагностики постменопаузальной остеопении. Доступно по: http://zhuravlev.info/modules.php?name=News&file=article&sid=145. [Strochkovа Y.О., Laptev V.Y., Gorbunov N.А. Application of the digital small dosage radiography for the diagnostics of the postmenopausal osteopenia. Available at: http://zhuravlev.info/modules.php?name=News&file=article&sid=145.

8. Hansen L., Mathiesen A.S., Vestergaard P. et al. A health economic analysis of osteoporotic fractures: who carries the burden? Arch Osteoporos 2013;8:126.

9. Новикова В.А., Аутлева Ф.Р., Хосева Е.Н. Современные возможности лечения и профилактики остеопороза у женщин в постменопаузе. Гинекология 2012;14(1):48–51. [Novikovа V.А., Аutlevа F.R., Hosevа Е.N. Modern opportunities of the osteoporosis prophylactics and treatment at women in the menopause. Ginekologiya = Gynecology 2012;14(1):48–51. (In Russ.)].

10. Цейтлин О.Я. Эпидемиология остеопороза. Вестник Академии медицинских наук 2002;(3):54–7. [Tseytlin О.Y. Osteoporosis epidemiology. Vestnik Akademii meditsinskikh nauk = Herald of the Academy of Medical Sciences 2002;(3):54–7. (In Russ.)].

11. Лирцман В.М., Зоря В.И., Гнетецкий С.Ф. Проблема лечения переломов шейки бедра на рубеже столетий. Вестник травматологии и ортопедии им. Н.Н. Приорова 1997;(2):12–8. [Lirstman V.М., Zorya V.I., Gnetetsky S.F. Problem of treatment of femoral fractures at the turn of the century. Vestnik travmatologii i ortopedii im. N.N. Priorova = N.N. Priorov Traumatology and Orthopedics Herald 1997;(2):12–8. (In Russ.)].

12. Gullberg B., Johnell O., Kanis J.A. Worldwide projections for hip fracture. Osteoporos Int 1997;7(5):407–13.

13. Мыркасымова А.К. Скрининг-диагностика нарушений минеральной плотности костной ткани у старших возрастных категорий населения города Актобе. Вестник Казахского национального медицинского университета 2013;(2):154–8. [Мyrkasymovа А.K. Screeningdiagnostics of damages of the mineral density of bone tissue at eldest age categories of Aktobe population. Vestnik Kazakhogo natsional’nogo meditsinskogo universiteta = Herald of Kazakh National Medical University 2013;(2):154–8. (In Russ.)].

14. van Balen R., Steyerberg E.W., Polder J.J. et al. Hip fracture in elderly patients: outcomes for function, quality of life, and type of residence. Clin Orthop Relat Res 2001;(390):232–43.

15. Kramer A.M., Steiner J.F, Schlenker R.E. et al. Outcomes and costs after hip fracture and stroke. A comparison of rehabilitation settings. JAMA 1997;277(5):396–404.

16. Melton L.J. 3rd. Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 2003;18(6):1139–41.

17. Iorio R., Healy W.L., Lemos D.W. et al. Displaced femoral neck fractures in the elderly: outcomes and cost effectiveness. Clin Orthop Relat Res 2001;(383):229–42.

18. Родионова С.С., Колондаев А.Ф., Солод Э.И. Комбинированное лечение переломов шейки бедренной кости на фоне остеопороза. Русский медицинский журнал 2004;12(24):1–8. [Rodionovа S.S., Kolondaev А.F., Solod E.I. Combined treatment of femoral fractures at the osteoporosis background. Russkiy meditsinskiy zhurnal = Russian Medical Journal 2004;12(24):1–8. (In Russ.)].

19. Кочиш А.Ю., Мироненко А.Н., Ласунский С.А., Стафеев Д.В. Возможности фармакологической коррекции постменопаузального остеопороза у пациенток с внесуставными переломами проксимального отдела бедренной кости. Травматология и ортопедия России 2011;2(60):50–6. [Kochish А.Yu., Мironenkо А.N., Lasunsky S.А., Stafeev D.V. Possibilities of the pharmacological correction of the postmenopausal osteoporosis at patients with abarticular fractures of the proximal femoral fracture. Travmatologiya i ortopediya Rossii = Тraumatology and Orthopedics in Russia 2011;2(60):50–6. (In Russ.)].

20. Шевалаев Г.А., Дёмин В.П., Волгаев Б.К., Ефремов И.М. Переломы проксимального отдела бедра у взрослых. Альманах современной науки и образования 2009;(5):181–2. [Shevalaev G.А., Dyomin V.P., Volgaev B.K., Еfremov I.М. Proximal Femoral Fractures at Adults. Al’manakh sovremennoy nauki i obrazovaniya = Аlmanac of the Modern Science and Education 2009;(5):181–2. (In Russ.)].

21. Климовицкий В.Г., Канзюба М.А., Канзюба А.И. Внутрисуставные переломы шейки бедренной кости у пациентов в возрасте до 50 лет (особенности механогенеза и лечения). Травма 2008;9(3):304–9. [Klimovitsky V.G, Kanzyubа М.А., Kanzyubа А.I. Intra-articular femoral fractures at patients at the age beyond 50 y.o. (peculiarities of the mechanical origin and treatment). Travma = Injury 2008;9(3):304–9. (In Russ.)].

22. Зоря В.И., Гнетецкий С.Ф., Гурьев В.В. К вопросу о тотальном эндопротезировании повреждений тазобедренного сустава у лиц старческого возраста. Бюллетень Восточно-Сибирского научного центра Сибирского округа РАМН 2006;(4):117–22. [Zorya V.I., Gnetetsky S.F., Guriev V.V. To the issue on the total hip arthroplasty at aged people. Bulleten’ Vostochno-Sibirskogo nauchnogo tsentra Sibirskogo okruga RAMN = Bulletin of the East-Siberian Scientific Center the Siberian District of RAMS 2006;(4):117–22. (In Russ.)].

23. Brox W.T., Roberts K.C., Taksali S. et al. The American Academy of Orthopaedic Surgeons Evidence-Based Guideline on Management of Hip Fractures in the Elderly. J Bone Joint Surg Am 2015;97(14):1196–9.

24. Jiang Y., Zhang Z.L., Zhang Z.L. et al. Menatetrenone versus alfacalcidol in the treatment of Chinese postmenopausal women with osteoporosis: a multicenter, randomized, double-blinded, double-dummy, positive drug-controlled clinical trial. Clin Interv Aging 2014;9:121–7.

25. Gregersen M., Mørch M.M., Hougaard K., Damsgaard E.M. Geriatric intervention in elderly patients with hip fracture in an orthopedic ward. J Inj Violence Res 2012;4(2):45–51.

26. Rostagno C. Cartei A., Buzzi R. et al. Multidisciplinary Approach to Hip Fracture in the Elderly: Florence Experience. Emergency Med 2013;3:148.

27. Солод Э.И., Лазарев А.Ф., Николаев А.В. Политензофасцикулярный остеосинтез при переломах шейки бедренной кости у больных пожилого и старческого возраста. Вестник травматологии и ортопедии им. Н.Н. Приорова 1998;(1):21–6. [Solod E.I., Lazarev А.F., Nicolaev А.V. Politense fascicular osteosynthesis at femoral fractures of elderly patients. Vestnik travmatologii i ortopedii im. N.N. Priorova N.N. Priorov Traumatology and Orthopedics Herald 1998;(1):21–6. (In Russ.)].

28. Лазарев А.Ф., Солод Э.И. Малоинвазивный перкутанный остеосинтез переломов шейки бедренной кости у пожилых больных на фоне остеопороза. Клиническая геронтология 2003;9(6):24–7. [Lazarev А.F., Solod E.I. Мinimally invasive percutaneous osteosynthesis of femoral fractures at elderly patients at the osteoporosis background. Klinicheskaya gerontologiya = Clinical Gerontology 2003;9(6):24–7. (In Russ.)].

29. Шигарев В.М., Новичков С.И. Остеосинтез чрезвертельных переломов бедренной кости у лиц старческого возраста. Гений ортопедии 2004;(4):99–100. [Shigarev V.М., Novichkov S.I. Оsteosynthesis of pertrochanteric femoral fractures at elderly people. Geniy ortopedii = Genius of Orthopedics 2004;(4):99–100. (In Russ.)].

30. Fensky F., Nüchtern J.V., Kolb J.P. et al. Cement augmentation of the proximal femoral nail antirotation for the treatment of osteoporotic pertrochanteric fractures a biomechanical cadaver study. Injury 2013;44(6):802–7.

31. Blankstein M., Widmer D., Götzen M. et al. Assessment of intraosseous femoral head pressures during cement augmentation of the perforated proximal femur nail antirotation blade. J Orthop Trauma 2014;28(7):398–402.

32. Erhart S., Kammerlander C., El-Attal R., Schmoelz W. Is augmentation a possible salvage procedure after lateral migration of the proximal femur nail antirotation? Arch Orthop Trauma Surg 2012;132(11):1577–81.

33. Erhart S., Schmoelz W., Blauth M., Lenich A. Biomechanical effect of bone cement augmentation on rotational stability and pull-out strength of the Proximal Femur Nail Antirotation. Ijury 2011;42(11):1322–7.

34. Родионова С.С., Макаров М.А., Колондаев А.Ф., Гаврюшенко Н.С. Значение минеральной плотности и показателей качества костной ткани в обеспечении ее прочности при остеопорозе. Вестник травматологии и ортопедии 2001;(2):76–80. [Rodionova S.S., Маkarov М.А., Kolondaev A.F., Gavrushenko N.S. The meaning of the mineral density and of bone tissue quality indices for the provision of its durability at osteoporosis. Vestnik travmatologii i ortopedii = Traumatology and Orthopedics Herald 2001;(2):76–80. (In Russ.)].

35. Akkus O., Adar F., Schaffler M.B. Agerelated changes in physicochemical properties of mineral crystals are related to impaired mechanical function of cortical bone. Bone 2004;34(3):443–53.

36. Huusko T.M., Karppi P., Kautiainen H. et al. Randomized, double–blind, clinically controlled trial of intranasal calcitonin treatment in patients with hip fracture. Calcif Tissue Int 2002;71(6):478–84.

37. Солод Э.И., Родионова С.С., Лазарев А.Ф. и др. Использование альфа-кальцидола и миакальцика в комплексном лечении внутри- и околосуставных переломов проксимального отдела бедренной кости у больных пожилого и старческого возраста. Остеопороз и остеопатии 1999;(1):37–9. [Solod E.I., Rodionova S.S., Lazarev A.F. et al. Use of alphacalcidol and miacalci in the comprehensive treatment of intraarticular and juxta-articular fractures of the proximal femoral section at elderly patients. Osteoporoz i osteopatii = Osteoporosis and Osteopathies 1999;(1):37–9. (In Russ.)].

38. Peng J., Liu Y., Chen L., et al. Bisphosphonates can prevent recurrent hip fracture and reduce the mortality in osteoporotic patient with hip fracture: A meta-analysis. Pak J Med Sci 2016;32(2):499–504.

39. Gupta A., March L. Treating osteoporosis. Aust Рrescr 2016;39(2):40–6.

40. Toussaint N.D., Elder G.J., Kerr P.G. Bisphosphonates in chronic kidney disease; balancing potential benefits and adverse effects on bone and soft tissue. Clin J Am Soc Nephrol 2009;4(1):221–33.

41. Black D.M., Reid I.R., Boonen S. et al. The effect of 3 versus 6 years of zoledronic acid treatment of osteoporosis: a randomized extension to the HORIZON-Pivotal Fracture Trial (PFT). J Bone Miner Res 2012;27(2):243–54.

42. Schwartz A.V., Bauer D.C., Cummings S.R. et al. Efficacy of continued alendronate for fractures in women with and without prevalent vertebral fracture: the FLEX trial. J Bone Miner Res 2010;25(5):976–82.

43. Родионова С.С., Солод Э.И, Лазарев А.Ф. Клинические рекомендации. Лечение патологических переломов шейки бедренной кости, возникших на фоне системного остеопороза. М., 2013. [Rodionova S.S., Solod E.I, Lazarev A.F. Clinical recommendations. Treatment of pathologic femoral fractures at the background of the systemic osteoporosis. Мoscow, 2013. (In Russ.)].

44. Nishii Y. Rationale for active vitamin D and analogs in the treatment of osteoporosis. J. Cell Biochem 2003;88(2):381–6.

45. Shiraki M., Fukuchi M., Kiriyama T. et al. Alfacalcidol reduces accelerated bone turnover in elderly women with osteoporosis. J Bone Miner Metab 2004;22(4):352–9.

46. Родионова С.С., Швец В.Н. Гистоморфометрическая оценка влияния различных фармпрепаратов на течение остеопороза. Остеопороз и остеопатии 1998;(3):36–8. [Rodionova S.S., Shvets V.N. Histomorphological evaluation of the influence of different pharmaceuticals on the osteoporosis treatment. Osteoporoz i osteopatii = Osteoporosis and Osteopathies 1998;(3):36–8. (In Russ.)].

47. Elders P.J., Netelenbos J.C., Lips P. et al. Calcium supplementation reduces vertebral bone loss in perimenopausal women a controlled trial in 248 women between 46 and 55 years of age. J Clin Endocrinol Metab 1991;73(3):533–40.

48. Long F. Building strong bones: molecular regulation of the osteoblast lineage. Nat Rev Mol Cell Biol 2011;13(1):27–38.

49. Bouillon R., Suda T. Vitamin D: calcium and bone homeostasis during evolution. Bonekey Rep 2014;3:480.

50. Захарова И.Н., Васильева С.В., Дмитриева Ю.А. и др. Коррекция недостаточности витамина D. Эффективная фармакотерапия 2014;(3):38–45. [Zakharovа I.N., Vasilievа S.V., Dmitrievа Y.А. et al. Correction of the vitamin D insufficiency. Effektivnaya farmakoterapiya = Effective Pharmaceutical Therapy 2014;(3):38–45. (In Russ.)].

51. Родионова С.С., Донская Г.А., Колондаев А.Ф. и др. Влияние творожистых фитопаст на гомеостаз кальция и метаболизм костной ткани. Остеопороз и остеопатии 2002;(2):17–8. [Rodionova S.S., Donskaya G.А., Kolondaev A.F. et al. Influence of clotty phytopastes on the bone tissue metabolism. Osteoporoz i osteopatii = Osteoporosis and Osteopathies 2002;(2):17–8. (In Russ.)].

52. Aloia J.F., Vaswani A., Yeh J.K. et al. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann Intern Med 1994;120(2): 97–103.


Review

For citations:


Zagorodniy N.V., Volna A.A., Panfilov I.I. A MULTIDISCIPLINARY APPROACH IN THE TREATMENT OF FRACTURES OF THE PROXIMAL FEMUR ON THE BACKGROUND OF SENILE OSTEOPOROSIS. The Clinician. 2016;10(2):18-24. (In Russ.) https://doi.org/10.17650/1818-8338-2016-10-2-18-24

Views: 1032


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-8338 (Print)
ISSN 2412-8775 (Online)