Features of functional activity indices and risk of osteoporotic fractures in patients with femoral and tibial fractures (results of 12-month observation)
Background. Nowadays, the lower limb fractures amount to from one third to half of all fractures, resulting in the increased incidence of morbidity and mortality. The incidence of complications after these fractures remains high, complete functional recovery is not observed in all patients. Appropriate assessment of functional activity of patients in the post-fracture period and the risk of subsequent fractures remain relevant. The purpose was to study the parameters of functional activity and the risk of osteoporotic fractures in patients of older age groups with lower limb fractures of different localization. Materials and methods. Seventy two subjects with proximal femoral fractures (PFF, n = 23) and tibial fractures (TF, n = 49) were examined. Longitudinal observation of patients was conducted for 12 months with the assessment of parameters before fracture (retrospectively), as well as 6 and 12 months after. Methods: questioning, general clinical, anthropometric and orthopedic examination. Questionnaire survey was conducted using the Lower Extremity Functional Scale (LEFS) and Fracture Risk Assessment Tool (FRAX), which patients filled in themselves under the control of a physician. Results. The parameters of LEFS are reliably related to the age, gender, height, body mass index, 10-year risk of major osteoporotic fractures and hip fractures in patients with TF. Data of LEFS in women with PFF before fracture are significantly worse than corresponding indices in patients with TF, and are also related to age. The parameters of LEFS in patients 6 months after PFF and TF are significantly lower compared to baseline, which indicates a deterioration of patient’s functional abilities. The LEFS indices in patients 12 months after PFF and TF significantly increase and do not differ from baseline parameters in persons with PFF, but not in patients with TF. The 10-year probability of risk for major osteoporotic fractures and hip fractures according to the FRAX does not significantly differ depending on fracture location, and is higher in women with TF than in men. Conclusions. All of the above should be taken into account when planning treatment, preventive and rehabilitation measures in elderly people with lower limbs fractures.
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