J Korean Med Assoc.  2016 Nov;59(11):857-865. 10.5124/jkma.2016.59.11.857.

Surgical or nonsurgical treatment of osteoporotic fractures

• Park SY
• Lee SH
• Jeong WK
• Kang CH

• KMID: 2358433
• DOI: http://doi.org/10.5124/jkma.2016.59.11.857

Abstract

The worldwide population of the elderly is steadily increasing, and even more so in Korea, thus causing an increase in the osteoporotic fracture prevalence. Osteoporotic fracture is a serious injury that can decrease quality of life, and can also produce major social problems when it causes mortality. Preventing such fractures from happening in the first place is of utmost importance but once a fracture does occur, it is important to select appropriate treatment modalities to prevent secondary fractures. Recently, with the increase of life expectancy, it has become favorable to perform surgical fixation for significantly displaced osteoporotic fractures and use early rehabilitation programs to return the patient to normal body performance as soon as possible. To do so, it is important to accurately assess the location and the degree of the fractures in order to select appropriate treatment modalities. Furthermore, it is important to prevent secondary fractures from happening once the previous fractures heal.

Keyword

Osteoporosis; Fractures; Therapeutics; Surgery; Conservative treatment

MeSH Terms

Aged
Humans
Korea
Life Expectancy
Mortality
Osteoporosis
Osteoporotic Fractures*
Prevalence
Quality of Life
Rehabilitation
Social Problems

Figure

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  Figure 1 Radiographs of a 65-year-old woman. (A) Standard plain lateral view of the lumbar spine showing a severely compressed fracture at T12. (B) Computed tomography scan showing the same finding as that in the standard lateral view of thelumbar spine. (C) Magnetic resonance imaging revealing acute fractures of T12 and L1.

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  Figure 2 Radiographs of an 81-year-old man. (A) Acute L3 compression fracture, (B) after cement augmentation at L3, and (C) anterior and posterior surgical reconstruction of lumbar spine for kyphosis after L3 compression fracture.

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  Figure 3 Radiographs of femur neck fracture and vaious surgical methods. (A) Femur neck fracture, (B) multiple pinning, and (C) bipolar hemiarthroplasty.

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  Figure 4 Radiographs of femur intertrochanteric fracture and various surgical methods. (A) Femur intertrochanteric fracture, (B) dynamic hip screw, (C) dynamic hip screw with TSP, and (D) proximal femoral nail.

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  Figure 5 Radiographs of atypical femoral fractures. (A) Subtrochanteric area, (B) shaft area, and (C,D) bilateral atypical femoral fractures at subtrochanteric area.

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  Figure 6 Radiographs of distal radius fracture and various surgical methods. (A) Distal radius fracture, (B) multiple pinning technique, and (C) plate fixation technique.

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  Figure 7 Radiographs of proximal humerus fracture and various surgical methods. (A) Proximal humerus fracture, (B) plate fixation technique, and (C) shoulder hemiarthroplasty.

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