Cort, B. de (Boris) (2018) Teendrukmeting als betrouwbare meting voor vaatstatus in onderbeenfracturen bij ouderen. thesis, Medicine.
Full text available on request.Abstract
Introduction: Fractures of the ankle, tibial plafond and tibial shaft are fractures that are associated with a high prevalence of postoperative complications. At older age the chance of these complications increases, as there are more co-morbidities. Several studies have shown that in addition to diabetes, smoking and male sex, the occurrence of peripheral arterial occlusive disease (PAOD) is an important risk factor for these complications. Complications not only affect fracture healing, but also quality of life and, in the worst case, lead to amputation of the extremity or death. This study focuses on the screening for PAOD / vascular status and the identification thereof as a risk factor for complications. Material and methods: Retrospectively, patients aged 60 or older whom presented themselves with fractures of the tibial plafond and tibial shaft in the period 2010-2017 were included. Possible risk factors and demographic characteristics were noted. In addition, a prospective study was conducted including all patients aged 60 or older who presented with a fracture of the ankle, tibial plafond or tibial shaft. The same parameters and characteristics were noted. Also in the prospective group a toe-pressure measurement and blood pressure measurement was performed of both the affected and the healthy extremity. An age-equal control group of patients with a distal radius fracture was formed. Results: In the retrospective group, 86 patients were included and in 30.7% of the cases there was a complication. After multivariate analysis of the risk factors, only male gender appeared to be a significant risk factor for complications. Prospectively, 16 patients were included and 29 in the control group. Vascular status was determined by means of toepressure measurement and toe/brachial index (TBI) derived therefrom. Both groups were found to have a comparable toe pressure and TBI. After further analysis, a reduced toe pressure did not appear to correlate significantly with the risk of complications. Conclusion: toe-pressure can be used as a measurement for vascular status in elderly patients with fractures of the lower leg. In order to link the reduced toe pressure to increased complication risk, however, more research is required and the study cohort needs to be enlarged.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Helden, dr. S.H. van and Traumachirurg |
| Supervisor name: | Secundair begeleider: and Oskam, dr. J. and Afdeling Traumachirurgie and Isala Ziekenhuis Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2083 |
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