Schmerzreduktion durch operative Therapie osteoporotischer Frakturen

 

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Zusammenfassung

Osteoporotische Frakturen führen aufgrund erheblicher Schmerzen und der damit verbundenen Funktionsstörungen zu einer signifikanten Einschränkung der körperlichen Leistungsfähigkeit. In den letzten Jahren konnten durch die Entwicklung neuer winkelstabiler Implantate, durch Zementaugmentation und den Einsatz von Frakturprothesen signifikante Fortschritte in der Behandlung von osteoporotischen Frakturen erzielt werden. Nachdem ältere Studien uneinheitliche Resultate aufwiesen, zeigen aktuelle Untersuchungen eindeutige Ergebnisse zu Gunsten der operativen Therapie. Im Rahmen eines narrativen Reviews soll die Wirkung der operativen Therapie auf die Schmerzreduktion und Verbesserung der Extremitäten dargestellt werden.

Abstract

Osteoporotic fractures are associated with a substantial mortality and morbidity. Because of persistent pain patients often suffer from a significant functional impairment and reduced quality of life. Recent progress in implant design and surgical technique has significantly improved the results of operative therapy of these fractures. Older studies did show conflicting results of operative therapy of osteoporotic fractures, but recent trials have demonstrated the superiority of operative therapy with regard to improvement of pain and function. The aim of this narrative review is to report on the impact of operative therapy on pain following major osteoporotic fractures.

Publication History

Received: 26 September 2023

Accepted: 18 January 2024

Article published online:
20 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

• Literatur

• 1 Adachi JD, Ioannidis G, Olsynski WR. et al. The impact of incident vertebral and non-vertebral fractures on health related quality of life in postmenopausal women. BMC Musculuskelet Disord 2003; 3: 11-18
  CrossrefPubMedGoogle Scholar
• 2 Clynes M, Harvey NC, Curtis EM. et al. The epidemiology of osteoporosis. Br Med Bull 2020; 133: 105-107
  PubMedGoogle Scholar
• 3 Briot K, Paternotte S, Kolta S. et al. FRAX®: prediction of major osteoporotic fractures in women from the general population: the OPUS study. PLOS One 2013; 8: e83436
  CrossrefPubMedGoogle Scholar
• 4 National Institute for Health and Care Excellence (NICE). Hip Fracture: Management Clinical Guideline. Online https://www.nice.org.uk/guidance/cg124 last accessed 26.09.2023
• 5 Abdulla A, Adams N, Bone M. et al. Guidance on the management of pain in older people. Age Aging 2013; 42: 1-57
  CrossrefPubMedGoogle Scholar
• 6 Calvo E, Morcillo D, Foruria A. et al. Nondisplaced proximal humeral fractures: high incidence among outpatient-treated osteoporotic fractures and severe impact on upper extremity function and patient subjective health perception. J Shoulder Elbow Surg 2011; 20: 795-801
  CrossrefPubMedGoogle Scholar
• 7 Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006; 37: 691-697
  CrossrefPubMedGoogle Scholar
• 8 Bartl C, Stengel D, Bruckner T. et al. Therapie der dislozierten intraartikulären distalen Radiusfraktur des älteren Patienten. Deutsches Ärzteblatt 2014; 111: 779-787
  Google Scholar
• 9 Saving J, Wahlgren S, Olsson K. et al. Nonoperative treatment compared with volar locking plate fixation for dorsally displaced distal radius fractures in the elderly. A randomized controlled trial. JBJS 2019; 101: 961-969
  CrossrefPubMedGoogle Scholar
• 10 Martinez- Mendez D, Lizaur-Utrilla a, de Juan Herrero J. Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating. J Hand Surg 2018; 43: 142-147
  CrossrefPubMedGoogle Scholar
• 11 MacDermid JC, Turgeon T, Richards RS. et al. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma 1998; 12: 577-586
  CrossrefPubMedGoogle Scholar
• 12 Jobin C, Galdi B, Anakwenze O. et al. Reverse shoulder arthoplasty for the management of proximal humerus fractures. JAAOS 2015; 23: 190-201
  CrossrefPubMedGoogle Scholar
• 13 Handoll HHG, Ollivere BJ, Rollins KE. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev 2012; 12: CD000434
  PubMedGoogle Scholar
• 14 Alcobia- Diaz B, Gallo- Oleros B, Garcia- Fernandez C. et al. JBJS 2020; 10: 906
• 15 Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006; 17: 1726-3173
  CrossrefPubMedGoogle Scholar
• 16 Lyritis GP, Mayasis B, Tsakalakos N. et al. The natural history of the osteoporotic vertebral fracture. Clin Rheumatol 1989; 8: 66-69
  PubMedGoogle Scholar
• 17 Wardlaw D, Cummings S, Meirhaeghe J. et al. Efficacy and safety of ballon kyphoplasty compared with non surgical care for vertebral compression fracture (FREE): a randomized controlled trial. Lancet 2009; 373: 1016-1024
  CrossrefPubMedGoogle Scholar
• 18 Liu F, Panagiotakos D. Real‑world data: a brief review of the methods, applications, challenges and opportunities. BMC Medical Research Methodology 2022; 22: 287-295
  CrossrefPubMedGoogle Scholar
• 19 Court- Brown CM, Grag A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand 2001; 72: 365-372
  CrossrefPubMedGoogle Scholar
• 20 Chen N, Jupiter J. Current concept review. Management of distal radial fractures. JBJS 2007; 89: 2051-2062
  CrossrefGoogle Scholar
• 21 Arora R, Lutz M, Deml C. et al. A prospective randomized trial comparing nonoperative treatment with volar locking plate fixation for displaced and unstable distal radial fractures in patients sixty-five years of age and older. JBJA(A) 2011; 93: 2146-2153
  Google Scholar
• 22 Selles CA, Mulder MAM, Winkelhagen J. et al. Volar plate fixation versus cast immobilization in acceptable reduced intra articular distal radial fractures. JBJS 2021; 103: 1963-1969
  CrossrefPubMedGoogle Scholar
• 23 Kyriakides P, Schultz B, Egol K. et al. The fragility and reverse fragility indices of proximal humerus fracture randomized controlled trials: a systematic review. European Journal of Trauma and Emergency Surgery 2022; 48: 4545-4552
  CrossrefPubMedGoogle Scholar
• 24 Handoll HHG, Elliott J, Thillemann TM. et al. Interventions for treating proximal humeral fractures in adults. Cochrane Database of Systematic Reviews 2022; 6: CD000434 DOI: 10.1002/14651858.CD000434.pub5.
  CrossrefPubMedGoogle Scholar
• 25 Stamm T, Pieber K, Crevenna R. et al. Impairment in the activities of daily living in older adults with and without osteoporosis, osteoarthritis and chronic back pain: a secondary analysis of population-based health survey data. BMC Musculoskelet Disord 2016; 28: 139-146 DOI: 10.1186/s12891-016-0994-y.
  CrossrefPubMedGoogle Scholar
• 26 Lyritis GP, Mayasis B, Tsakalakos N. et al. The natural history of the osteoporotic vertebral fracture. Clin Rheumatol 1989; 8: 66-69
  CrossrefPubMedGoogle Scholar
• 27 Papanastassiou ID, Phillips FM, Van Meirhaeghe J. et al. Comparing effects of kyphoplasty, vertebroplasty, and nonsurgical management in a systematic review of randomized and non-randomized controlled studies. Eur Spine J 2012; 21: 1826-1843
  CrossrefPubMedGoogle Scholar
• 28 Halvachizadeh S, Stalder A, Bellut D. et al. Systematic Review and Meta-Analysis of 3 Treatment Arms for Vertebral Compression FracturesA Comparison of Improvement in Pain, Adjacent-Level Fractures, and Quality of Life Between Vertebroplasty, Kyphoplasty, and Nonoperative Management. JBJS Reviews 2021; 9: e21.00045 DOI: 10.2106/JBJS.RVW.21.00045.
  CrossrefPubMedGoogle Scholar
• 29 Kanis JA, Cooper C, Rizzoli R. et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis Int 2019; 30: 3-44
  CrossrefPubMedGoogle Scholar