Related Experiment Video
Updated: Sep 29, 2025
09:46
Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton
Published on: June 16, 2016
20.8K
Risk Factors and Consequences of Lower Extremity Fracture Nonunions in Veterans With Spinal Cord Injury
Bridget Sinnott1, Cara Ray2, Frances Weaver2,3
1Charlie Norwood Veterans Affairs Medical Center Augusta GA USA.
JBMR Plus
|March 21, 2022
Summary
Older veterans with long-term spinal cord injuries and disorders (SCID) who fracture their distal femur face a high risk of nonunion. These nonunions lead to severe complications like pressure injuries, osteomyelitis, and amputation, necessitating targeted interventions.
Area of Science:
- Orthopedics
- Traumatology
- Rehabilitation Medicine
Background:
- Lower extremity fractures are a significant concern in veterans with spinal cord injuries and disorders (SCID).
- Fracture nonunion can lead to substantial morbidity and impact functional outcomes.
- Identifying risk factors and consequences is crucial for improving patient care.
Purpose of the Study:
- To determine risk factors for lower extremity fracture nonunion in veterans with SCID.
- To identify the consequences and complications associated with these nonunions.
- To define a high-risk population for targeted interventions.
Main Methods:
- Utilized Veterans Health Administration (VHA) national administrative data from fiscal years 2005-2014.
- Identified a cohort of veterans with SCID and lower extremity fractures.
- Employed multivariable-adjusted logistic regression to compute odds ratios (OR) for fracture nonunion.
Main Results:
- Older age (OR=2.29), longer duration of SCID (OR=1.02), and distal femur fracture site were significant risk factors for nonunion.
- Fracture nonunions resulted in serious complications: pressure injuries (upwards of 1/3), osteomyelitis (13%), and subsequent amputation (almost 25%).
- A high-risk population identified: older veterans with long-duration SCID sustaining distal femur fractures.
Conclusions:
- Older veterans with SCID and distal femur fractures are at high risk for fracture nonunion.
- Nonunions in this population lead to severe complications, including amputation.
- Early identification and targeted interventions for signs of delayed union in high-risk individuals are recommended.
Keywords:
FEMUR FRACTURESFRACTURE NONUNIONFRACTURE‐RELATED COMPLICATIONSSPINAL CORD INJURY AND DISORDERSMore Related Videos
Related Concept Videos
01:26Varicose Veins I: Introduction
32
Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
32
01:23Peripheral Artery Disease V: Postoperative Nursing Management
37
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
37
01:30Venous Thrombosis I: Introduction
52
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
52
01:30Venous Thrombosis IV: Nursing Management
40
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
40