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Fractures and handicap in an adult population: A clinical study.

机译：成人人群的骨折和残障：一项临床研究。

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OBJECTIVE: To evaluate the bone status of ambulatory patients with physical and mental handicaps before a program of fracture prevention. METHODS: We recruited 58 walking adults. We retrospectively collected the past episodes of fractures, essentially peripheral, and epilepsy. The serum calcium, albumin, 25-hydroxyvitamin D, parathormone, CTX-1 and P1NP levels were prospectively measured in 36 consecutive patients. Each patient received daily calcium and vitamin D. The vertebral status has been not evaluated. RESULTS: Twenty-one patients had presented at least one fracture. Thirty nine per cent of the fractures were minor (nasal bone, hands, feet). The age of patients with fractures was significantly higher than patients without fracture (46 versus 40years, respectively; p=0.04). Patients with fractures had a significantly increased S-P1NP (63.5ng/ml+/-32.0 versus 41.9ng/ml+/-20.0, respectively; p=0.02). Nineteen patients suffered from epilepsy. We listed 23 fractures among 9 patients treated by phenobarbital and 8 fractures, which tended to be less severe among 5 patients epileptics without this drug. Minor fracture was often followed by severe fracture in case of phenobarbital treatment. This treatment was associated with a significantly lower serum calcium level (2.16mmol/l+/-0.05, versus epileptic patients without phenobarbital 2.32mmol/l+/-0.08, p<0.0004). CONCLUSIONS: The presence of a fracture, even minor, must encourage to improve the preventive and curative measures among patients with handicaps.
机译：目的：在进行骨折预防计划之前，评估患有身体和精神障碍的非卧床患者的骨骼状况。方法：我们招募了58名步行成年人。我们回顾性收集过去的骨折事件，主要是周围性和癫痫发作。前瞻性测量36例连续患者的血清钙，白蛋白，25-羟基维生素D，副激素，CTX-1和P1NP水平。每个患者每天接受钙和维生素D。椎骨状态尚未评估。结果：21例患者至少出现了一次骨折。 39％的骨折为轻度骨折（鼻骨，手，脚）。骨折患者的年龄显着高于非骨折患者（分别为46岁和40岁; p = 0.04）。骨折患者的S-P1NP显着增加（分别为63.5ng / ml +/- 32.0和41.9ng / ml +/- 20.0; p = 0.02）。 19名患者患有癫痫病。我们列出了经苯巴比妥治疗的9例患者中的23处骨折和8例骨折，在没有这种药物的5例癫痫患者中，这种情况的严重性较轻。在苯巴比妥治疗的情况下，轻度骨折经常伴有严重骨折。与没有苯巴比妥的癫痫患者2.32mmol / l +/- 0.08相比，该治疗与血清钙水平显着降低（2.16mmol / l +/- 0.05，p <0.0004）有关。结论：即使是很小的骨折，也必须鼓励改善残障患者的预防和治疗措施。

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