Accession Number : AD1047441


Title :   Pathomechanics of Post-Traumatic OA Development in the Military Following Articular Fracture


Descriptive Note : Technical Report,30 Sep 2016,29 Sep 2017


Corporate Author : The University of Iowa Iowa City United States


Personal Author(s) : Anderson,Donald D


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/1047441.pdf


Report Date : 01 Oct 2017


Pagination or Media Count : 142


Abstract : The objective of this research is to develop new models for predicting the risk of post-traumatic osteoarthritis (PTOA) following intra-articular fracture (IAF). We have analyzed pre- and post-treatment CT data from patients with combat-related IAFs to measure fracture severity and post reduction contact stress exposure. Our partner at SAMMC continues screening the DoDTR to identify and enroll subjects. The imaging data for 57 subjects with collectively 95 fractures have been forwarded to us for analysis, and we have completed fracture severity analysis of 71 IAFs. This is in addition to fracture energies having now been computed for 226 civilian IAFs. In a preliminary analysis of our military data, we found that fracture energy can predict painful and activity-limiting PTOA, which contributes to late amputation in military blast injuries. Twenty military subjects with tibial pilon IAFs resulting from blast injuries were studied. Of the 15 subjects with sufficient follow-up data, 5 limbs were amputated. There was a statistically significant difference in the fracture energies of the amputation and retained limb groups (17.4 vs 6.6 J, respectively; p=0.0059). An objective fracture severity score nearly perfectly predicted amputation. During the coming year, we will be performing additional analysis of fracture severity in more cases to further test these findings.


Descriptors :   ARTHRITIS , MILITARY PERSONNEL , COMBAT INJURIES , BONE FRACTURES


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE