Best Practices for Management of Fractures in Spinal Cord Injuries and Disorders

脊髓损伤和疾病骨折管理的最佳实践

• 批准号: 10179490
• 负责人: LAURA D CARBONE
• 金额: --
• 依托单位: CHARLIE NORWOOD VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2020-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179490
• 关键词: Acute; Adverse event; Amputation; Area; Bone Density; Caring; Clinical; Consensus; Data; Data Set; Decision Making; Disease; Event; Femoral Fractures; Fracture; Future; Goals; Guidelines; Heterotopic Ossification; Hospitals; Hour; Infection; Interview; Lead; Lesion; Literature; Location; Lower Extremity; Lower Extremity Fracture; Morbidity - disease rate; Operative Surgical Procedures; Orthopedics; Osteoporotic; Patient Care; Patients; Perception; Personal Communication; Physicians; Population; Practice Management; Process; Prospective Studies; Provider; Publishing; Questionnaires; Reporting; Research; Sampling; Severities; Site; Spinal cord injury; Structure; Surgeon; Surgical Disarticulation; Surveys; Testing; Time; Treatment outcome; Veterans; Work; acute care; administrative database; adverse outcome; base; bone loss; care outcomes; decubitus ulcer; demographics; experience; health care model; health care service utilization; men; mortality; optimal treatments; osteoporosis with pathological fracture; patient population; repaired; residence; support tools

Osteoporotic-related fractures are a serious problem for patients with Spinal Cord Injury (SCI). However, best management for acute care of these fractures including whether surgical vs. nonsurgical treatment should be done and the factors that influence this decision is not known. This point is well appreciate by providers, who have identified to SCI QUERI that research to establish best practices for treatment of fractures in patients with a SCI should be a priority area. Surgical treatment for lower extremity fractures is done more frequently than previously reported, with approximately 10-37% of these fractures now managed surgically. However, the factors that influence the choice of surgical vs. nonsurgical fracture treatments and outcomes following these therapies have not been described. In this proposal we will utilize administrative databases, semi-structured questionnaires and case scenarios, and convene an outstanding advisory panel to review this information and existing literature to start the process of understanding best management for osteoporotic fractures in SCI. We will include both patients and providers (orthopedic surgeons and PM&R physicians) in the surveys. This proposal is of direct, immediate potential clinical benefit to the expanding population of patients with SCI. It will provide invaluable information for providers to better be able to care for these patients when they sustain an osteoporotic fracture.

骨质疏松性骨折是脊髓损伤（SCI）患者的严重问题。然而，最好 这些骨折的急性护理管理，包括是否应该手术与非手术治疗， 这一决定已经完成，影响这一决定的因素尚不清楚。这一点得到了供应商的充分赞赏，他们 我已经向SCI QUERI确定了研究，以建立治疗骨折患者的最佳实践， SCI应该是一个优先领域。下肢骨折的手术治疗比 以前报道过，这些骨折中约有10-37%现在通过手术治疗。但 影响手术与非手术骨折治疗选择的因素以及这些因素之后的结果 尚未描述治疗方法。在本提案中，我们将利用半结构化的管理数据库， 调查问卷和案例情景，并召集一个杰出的咨询小组审查这一信息， 现有的文献，开始了解最佳的管理过程中，脊髓损伤。 我们将在调查中包括患者和提供者（整形外科医生和PM&R医生）。这 该提案对不断扩大的SCI患者群体具有直接、立即的潜在临床益处。它将 为提供者提供宝贵的信息，以便能够更好地照顾这些患者， 骨质疏松性骨折

项目成果

Treatment of Lower Extremity Fractures in Chronic Spinal Cord Injury: A Systematic Review of the Literature.

慢性脊髓损伤下肢骨折的治疗：文献的系统回顾。

• DOI: 10.1002/pmrj.12428
• 发表时间: 2021
• 期刊: PM & R : the journal of injury, function, and rehabilitation
• 作者: Huang,Donna;Weaver,Frances;Obremskey,WilliamT;Ahn,Jaimo;Peterson,Kimberly;Anderson,Johanna;Veazie,Stephanie;Carbone,LauraD
• 通讯作者: Carbone,LauraD

Spinal cord injury providers' perspectives on managing sublesional osteoporosis.

脊髓损伤提供者对治疗病变下骨质疏松症的看法。

• DOI: 10.1080/10790268.2019.1704552
• 发表时间: 2020
• 期刊: The journal of spinal cord medicine
• 作者: Weaver,FrancesM;Etingen,Bella;Guihan,Marylou;Ray,Cara;Priebe,Michael;Burns,Stephen;Carbone,Laura
• 通讯作者: Carbone,Laura

Prevention and management of osteoporosis and osteoporotic fractures in persons with a spinal cord injury or disorder: A systematic scoping review.

脊髓损伤或疾病患者骨质疏松症和骨质疏松性骨折的预防和管理：系统范围审查。

• DOI: 10.1080/10790268.2018.1469808
• 发表时间: 2019
• 期刊: The journal of spinal cord medicine
• 作者: Zleik,Nour;Weaver,Frances;Harmon,RobertL;Le,Brian;Radhakrishnan,Reshmitha;Jirau-Rosaly,WandaD;Craven,BCatharine;Raiford,Mattie;Hill,JenniferN;Etingen,Bella;Guihan,Marylou;Heggeness,MichaelH;Ray,Cara;Carbone,Laura
• 通讯作者: Carbone,Laura