title: Long-bone fractures in persons with spinal cord injury.
abstract: METHODS
  Retrospective data analysis.
  
  
  OBJECTIVE
  To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI).
  
  
  METHODS
  Rehabilitation centre for SCI individuals.
  
  
  METHODS
  Patients' records were reviewed. Patients with traumatic SCI and extremity fractures that had occurred after SCI were included. Patient characteristics, fractured bone, fracture localisation, severity and management (operative/conservative), and fracture-related complications were extracted.
  
  
  RESULTS
  A total of 156 long-bone fractures in 107 SCI patients (34 women and 73 men) were identified. The majority of patients were paraplegics (77.6%) and classified as American Spinal Injury Association Impairment Scale A (86.0%). Only the lower extremities were affected, whereby the femur (60.9% of all fractures) was fractured more frequently than the lower leg (39.1%). A total of 70 patients (65.4%) had one fracture, whereas 37 patients (34.6%) had two or more fractures. Simple or extraarticular fractures were most common (75.0%). Overall, 130 (83.3%) fractures were managed operatively. Approximately half of the femur fractures (48.2%) were treated with locking compression plates. In the lower leg, fractures were mainly managed with external fixation (48.8%). Conservative fracture management was applied in 16.7% of the cases and consisted of braces or a well-padded soft cast. Fracture-associated complications were present in 13.5% of the cases but did not differ significantly between operative (13.1%) and conservative (15.4%) fracture management.
  
  
  CONCLUSIONS
  SCI was associated with simple or extraarticular fractures of the distal femur and the lower leg. Fractures were mainly managed operatively with a low complication rate.
authors.affiliation: Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Frotzler
authors.affiliation: Department of Orthopaedics, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Cheikh-Sarraf
authors.affiliation: Department of Orthopaedics, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Pourtehrani
authors.affiliation: Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Krebs
authors.affiliation: Department of Osteoporosis, Inselspital, Berne University Hospital and University of Berne, Berne, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Lippuner
mesh_terms: D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D007869:Leg Injuries / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D010264:Paraplegia / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology* / Q000503:physiopathology