Shoulder & Elbow Journal Scan

BACKGROUND: Fragility fractures are a major public health issue with substantial socioeconomic cost. Vitamin-D deficiency and increased bone turnover are associated with higher rates of bone loss and an increased risk of fracture. We hypothesized that patients with a distal radial fracture would have lower levels of 25-hydroxyvitamin D (25[OH]D) and increased levels of serum bone turnover markers than controls without a fracture.

METHODS: Postmenopausal women with a recent distal radial fracture (fracture group, n = 105) were prospectively recruited and were compared with individuals without a fracture (control group, n = 150). Outcome variables included serum levels of 25(OH)D and markers of bone formation, including N-terminal extension propeptide of type-I collagen (P1NP), parathyroid hormone (PTH), bone-specific alkaline phosphatase (BSAP), and osteocalcin, as well as a marker of resorption (C-terminal telopeptide of type-I collagen [CTX-1]).

BACKGROUND: Revision of a shoulder arthroplasty to a reverse shoulder arthroplasty in the presence of glenoid bone loss is especially challenging. The purpose of the present study was to determine the complications and results of glenoid bone-grafting in revision to a reverse shoulder arthroplasty.

METHODS: Between 2005 and 2010, 143 consecutive reverse shoulder arthroplasties performed as revision procedures were performed at our institution. Glenoid bone-grafting was performed in forty-one shoulders (29%), with 98% (forty) that had follow-up of more than two years (mean, 3.1 years). The 102 patients who did not undergo grafting served as a control group.

RESULTS: Seven patients (18%) required another revision surgery because of glenoid loosening (four patients), instability (two patients), or infection (one patient).

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