Cervical fractures of femoral bone in eldery patients: epidimeology and causative fractures (literature review)

Authors

  • Tamara Hurbanova
  • Vladimir Babalyan
  • Dmytro Cherepov
  • Andrii Kalchenko

DOI:

https://doi.org/10.15674/0030-598720173114-122

Keywords:

femoral neck fracture, elderly and senile age, risk factors, epidemiology

Abstract

Оccurrence, prevalence and treatment of femoral neck fractures among the elderly and senile were analyzed. The structure of a contingent of patients with fractures of the indicated localization is considered. It is shown that 95 % of people the older age group, femoral neck fractures fractures arise due to low-energy injury. However, there is a clear tendency to increase the number of injuries on the background of osteoporosis in the age group of 40–60 years. Geographical differences in frequency of of the proximal femur fracture occurrence on different continents, as well as between different regions which is determined in a certain way by the genetic environmental factors. For example, it is proved the influence of the amount of sunlight on the frequency of fractures often occur in the winter due to vitamin D deficiency and a decrease in neuromuscular coordination. It is shown that female sex is a risk factor for proximal femur fractures: the ratio of a woman/man aged 60– 69 is 9:2. Wherein women have an absolute number of fractures constantly grows with age. Among other reasons that can lead to the emergence of proximal femur fractures are called: a decrease in bone mineral density, a prolonged glucocorticoids administration, low body weight, smoking, alcohol abuse In Ukraine, there is no official statistics on the prevalence of proximal femur fractures, data on the state of medical services to assist such patients are disparate, the medical and social consequences of treatment outcomes by various methods are practically not analyzed. The results of epidemiological studies may become the foundation for the development of a scientifically sound regional program for the prevention and treatment of proximal femur fractures.

Author Biographies

Tamara Hurbanova

Kharkiv Medical Academy for Postgraduate Education of the Ministry of Health of Ukraine
CHI «17 municipal multidisciplinary hospital of Kharkiv». Ukraine

tamaragurbanova1@rambler.ru

Vladimir Babalyan

Kharkiv Medical Academy for Postgraduate Education of the Ministry of Health of Ukraine

PhD

babalyanvladimir@gmail.com

Dmytro Cherepov

Kharkiv Medical Academy for Postgraduate Education of the Ministry of Health of Ukraine

dmcherepov@gmail.com

Andrii Kalchenko

Kharkiv Medical Academy for Postgraduate Education of the Ministry of Health of Ukraine
CHI «17 municipal multidisciplinary hospital of Kharkiv». Ukraine

didandrij@ukr.net

References

  1. Ankin NL, Ankin LN. Traumatology. European standards for diagnosis and treatment. Kiev: Kniga-plus, 2012. 464 p. (in Russian)
  2. Batudaeva TI, Spasova TE, Zandanov AO. Mineral density of bone tissue as a risk factor for osteoporotic fractures. Siberian Medical Journal. 2013;1:95-97.
  3. Belinov NV. Evolution of surgical methods of treatment of femoral neck fractures. Siberian Medical Journal. 2013;5:22-25. (in Russian)
  4. Kozhakhmetova Zh, Rakhimzhanova RI, Batpenov ND, Turmukhambetova AA. Influence of geometric parameters on the risk of proximal femur fractures. Traumatology and Orthopedics. 2005;1:40–42. (in Russian)
  5. Grigoryeva NV, Povoroznyuk VV, Zubach OB, Povoroznyuk VV. Geometry of the proximal region of the femoral bone and risk of its fractures: a literature review. Pain. Joints. Spine. 2016;1:21–28. (in Ukrainian)
  6. Grigoryeva NV, Zubach OB. Age and gender features of femoral bone geometry in patients with different types of fractures of the upper third of the femur. Problems of Osteology. 2015;3:12–21. (in Ukrainian)
  7. Povoroznyuk VV, Grigoryeva NV, Korzh MO, et al. Epidemiology of fractures of the proximal femur bone in Ukraine: results of the OFRS study: (Osteoporotic fractures registration system). Trauma. 2016;5:14-20. doi: 10.22141/1608-1706.5.17.2016.83870. (in Ukrainian)
  8. Rodionova SS, Makarov MA, Kolondayev AF, et al. Significance of mineral density and quality indices of bone tissue in ensuring its durability in osteoporosis. NN. Prioryov Bulletin of Traumatology and Orthopedics. 2001;2:76-80. (in Russian)
  9. Ismailov SI, Khodzhambirdieva DSh, Riksheyeva NT. Osteoporosis and low-energy fractures of the femoral neck as a complication of various endocrine diseases: (review of literature). International Endocrinology Journal. 2013;5:113–20. (in Russian)
  10. Ershova OB, Belova KYu, Ganert OA, et al. Outcome of osteoporotic proximal femur fractures. Clinical Gerontology. 2014;3–4:3–8. (in Russian)
  11. Shimon VM, Litvak VV, Shimon MV, Sheregiy AA. Conservative therapy in complex treatment of elderly patients after endoprosthesis replacement. Trauma. 2014;3:80-81. (in Ukrainian)
  12. Gorbunov NS, Tutinin KV, Rostovtsev SI, et al. Constitutional differences of elderly women with trochanteric fractures and fractures of the neck of the femur. In the World of Scientific Discoveries. 2015;7:9-22. (in Russian)
  13. Krivova AV, Timaev RV, Rodionova SS. Epidemiology of fractures of the proximal femur in the population of Tver city. NN. Priorov Bulletin of Traumatology and Orthopаedics. 2006;2:17-20. (in Russian)
  14. Lesnyak OM. Assessment of the issue of osteoporosis in Eastern Europe and Central Asia 2010. International Osteoporosis Foundation, 2011. 68 p. (in Russian)
  15. Lesnyak OM, Baranova IA, Toroptsova NV. Diagnosis, prevention and treatment of glucocorticoid osteoporosis in men and women aged 18 years and older. Yaroslavl: Litera, 2013. 48 p. (in Russian)
  16. Loskutov AE, Degtyar AV. Endoprosthesis replacement in elderly patients with medial fractures of the femoral neck and their consequences. Problems of Osteology. 2011;1:35-9. (in Russian)
  17. Lvov SE, Pisarev VV, Kuzmin AM. Does the incidence of femoral neck fractures depend on the mineral density of bone tissue? Modern Problems of Science and Education. 2011;6:29-36. (in Russian)
  18. Nasonov EL. Problems of osteoporosis in men. Russian Medical Journal. 2003;23:1308-1311. (in Russian)
  19. Klimovitskiy VG, Kanzyuba MA, Kanzyuba AI, et al. Peculiarities of osteosynthesis of femoral neck fractures at young age. Trauma. 2013;2:6-11. (in Russian)
  20. Gertsen GІ, Pronik AI, Ostapchuk MP, Amir M. Fractures of the femoral neck in elderly and senile patients. Kyiv: Stal, 2003. 170 p. (in Ukrainian)
  21. Povoroznyuk VV, Vayda VM, Dzerovych NI. Age and gender features of the incidence of femoral fractures in the population of the Transcarpathian region. Problems of Aging and Longevity. 2011;1:99-106. (in Ukrainian)
  22. Rodionova SS, Kolondayev AF, Solod EI. Combined treatment of fractures of the femoral neck secondary to osteoporosis. Russian Medical Journal. 2004;24:1-8. (in Russian)
  23. Rozhinskaya LYa. Systemic osteoporosis: practical guide. 2nd edition, revised and enlarged M.: Makeev, 2000. 196 p. (in Russian)
  24. Distribution of the permanent population of Ukraine by gender and age by January 1, Statistical digest. Kyiv, 2016. 348 p. (in Ukrainian)
  25. Romanov GN, Savasteyeva IG. Estimation of incidence of risk factors and their influence on the relative risk of osteoporotic fractures of the femoral neck. Problems of Health and Ecology. 2011;4:142-6. (in Russian)
  26. Rodionova SS, Torgashin AN, Solod EI, et al. Structural parameters of the proximal femur in the assessment of its durability. NN. Priorov Bulletin of Traumatology and Orthopedics. 2014;1:77-81. (in Russian)
  27. Guryev SO, Tanasienko PV, Shkatula YuV, et al. Traumogenesis and medical-social consequences of involutive fractures of the proximal femur bone. Bulletin of the Vinnytsia National Medical University. 2015;1:201-4. (in Ukrainian)
  28. Kanzyuba AI, Donchenko LI, Kanzyuba MA, Chuchvareva SS. Endoprosthesis replacement of the hip joint in femoral neck fractures secondary to involutive osteoporosis. Problems of Osteology. 2012;1:70-73. (in Russian)
  29. Kanis JA, Johansson H, Oden A, Johnell O, de Laet C, Melton III LJ, Tenenhouse A, Reeve J, Silman AJ, Pols HA, Eisman JA, McCloskey EV, Mellstrom D. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res. 2004;19(6):893–9. doi: 10.1359/JBMR.040134.
  30. Sugiyama T, Kono Y, Sekiguchi K, Kim YT, Oda H. Age-related fragility fracture: insights from the natural homeostatic system in the skeleton. Arch Osteoporos. 2015;10(45). doi: 10.1007/s11657-015-0251-2.
  31. Zhang X, Yu Z, Yu M, Qu X. Alcohol consumption and hip fracture risk. Osteoporosis Int. 2015;26(2):531–42. doi: 10.1007/s00198-014-2879-y.
  32. Høidrup S, Grønbaek M, Gottschau A, Lauritzen JB, Schroll M. Alcohol intake, beverage preference, and risk of hip fracture in men and women. Am J Epidemiol. 1999;149(11):993–1001.
  33. Amin S, Felson DT. Osteoporosis in men. Rheum Dis Clin North Am. 2001;27:19–47.
  34. Damji AN, Bies K, Alibhai SM, Jones JM. Bone health management in men undergoing ADT: examining enablers and barriers to care. Osteoporos Int. 2015;26(3):951–9. doi: 10.1007/s00198-014-2997-6.
  35. Mittan D, Lee S, Miller E, Perez RC, Basler JW, Bruder JM. Bone loss following hypogonadism in men with prostate cancer treated with GnRH analogs. J Clin Endocrinol Metab. 2002;87(8):3656–61.
  36. Briot K, Maravic M, Roux C. Changes in number and incidence of hip fractures over 12 years in France. Bone. 2015;81:131–7. doi: 10.1016/j.bone.2015.07.009.
  37. Cauley JA, Kassem AM, Fuleihan GH. Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol. 2014;10(6):338–51. doi: 10.1038/nrendo.2014.51.
  38. Cauley JA. Osteoporosis: fracture epidemiology update 2016. Curr Opin Rheumatol. 2017;29(2):150–6. doi: 10.1097/BOR.0000000000000365.
  39. Lee DR, Lee J, Rota M, Lee J, Ahn HS, Park SM, Shin D. Coffee consumption and risk of fractures: a systematic review and dose-response meta-analysis. Bone. 2014;63:20–8. doi: 10.1016/j.bone.2014.02.007.
  40. Sheng J, Qu X, Zhang X, Zhai Z, Li H, Liu X, Li H, Liu G, Zhu Z, Hao Y, Qin A, Dai K. Coffee, tea, and the risk of hip fracture: a meta-analysis. Osteoporosis Int. 2014;25(1):141–50. doi: 10.1007/s00198-013-2563-7.
  41. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: A world-wide projection. Osteoporosis Int. 1992;2:285–9.
  42. Dhanwal DK, Cooper C, Dennison EM. Dennison. Geographic Variation in Osteoporotic Hip Fracture Incidence: The Growing Importance of Asian Influences in Coming Decades [web source]. Journal of Osteoporosis. 2010. Available from: https://www.hindawi.com/journals/ jos/2010/757102/.
  43. Lehmann R, Wapniarz M, Hofmann B, Pieper B, Haubitz I, Allolio B. Drinking water fluoridation: bone mineral density and hip fracture incidence. Bone. 1998;22:273–8.
  44. Park EY, Hwang SS, Kim JY, Cho SH. Effects of long-term fluoride in drinking water on risks of hip fracture of the elderly: an ecologic study based on database of hospitalization episodes. J Prev Med Public Health. 2008 May;41(3):147-52.
  45. Daniachi D, Netto Ados S, Ono NK, Guimarães RP, Polesello GC, Honda EK. Epidemiology of fractures of the proximal third of the femur in elderly patients. Rev Bras Ortop. 2015;50(4):371-7. doi: 10.1016/j.rboe.2015.06.007.
  46. Dhanwal DK, Dennison EM, Harvey NC, Cooper C. Epidemiology of hip fracture: worldwide geographic variation. Indian J Orthop. 2011;45(1):15-22. doi: 10.4103/0019-5413.73656.
  47. Näsman P, Ekstrand J, Granath F, Ekbom A,Fored CM. Estimated drinking water fluoride exposure and risk of hip fracture: a cohort study. J Dent Res. 2013 Nov;92(11):1029-34. doi: 10.1177/0022034513506443.
  48. Yin XH, Huang GL, Lin DR, Wan CC, Wang YD, Song JK, Xu P Exposure to fluoride in drinking water and hip fracture risk: a meta-analysis of observational studies. PLoS One. 2015;10(5):e0126488. doi: 10.1371/journal.pone.0126488.
  49. Kurttio P, Gustavsson N, Vartiainen T, Pekkanen J. Exposure to natural fluoride in well water and hip fracture: a cohort analysis in Finland. Am J Epidemiol. 1999 Oct 15;150(8):817-24.
  50. Hillier S, Cooper C, Kellingray S, Russell G, Hughes H, Coggon D. Fluoride in drinking water and risk of hip fracture in the UK: a case-control study. Lancet. 2000;355:265-9.
  51. Poole KE, Skingle L, Gee AH, et al. Focal osteoporosis defects play a key role in hip fracture. Bone. 2017;94:124-34. doi: 10.1016/j.bone.2016.10.020.
  52. Chen Z, Maricic M, Bassford TL, Pettinger M, Ritenbaugh C, Lopez AM, Barad DH, Gass M, Leboff MS. Fracture risk among breast cancer survivors: results from the Women’s Health Initiative Observational Study. Arch Intern Med. 2005;165(5):552-8. doi:10.1001/archinte.165.5.552.
  53. Chen JS, Simpson JM, March LM, Cameron ID, Cumming RG, Lord SR, Seibel MJ, Sambrook PN. Fracture risk assessment in frail older people using clinical risk factors. Age Ageing. 2008 Sep;37(5):536-41. doi: 10.1093/ageing/afn128.
  54. Endo Y, Aharonoff GB, Zuckerman JD, Egol KA, Koval KJ. Gender differences in patient swith hip fracture: agreater risk of morbidity and mortality in men. J Orthop Trauma. 2005;19(l):29-35.
  55. Cauley JA, Chalhoub D, Kassem AM, Gel-H. Fuleihan Geographic and ethnic disparities in osteoporotic fractures. Nat Rev Endocrinol. 2014;10(6):338-51. doi: 10.1038/nrendo.2014.51.
  56. Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B. Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int. 2011;22(10):2575-86. doi: 10.1007/s00198-011-1596-z.
  57. Canalis E, Mazziotti G, Giustina A, Bilezikian JP. Glucocorticoid-induced osteoporosis : pathophysiology and therapy. Osteoporos Int. 2007;18(10):1319-28. doi: 10.1007/s00198-007-0394-0.
  58. Henneicke H, Gasparini SJ, Brennan-Speranza TC, Zhou H1, Seibel MJ Glucocorticoids and bone: local effects and systemic implications. Trends Endocrinol Metab. 2014;25(4):197-211. doi: 10.1016/j.tem.2013.12.006.
  59. Smith MR, Lee WC, Brandman J, Wang Q, Botteman M, Pashos CL. Gonadotropin-releasing hormone agonists and fracture risk: a claims-based cohort study of men with non metastatic prostate cancer. J Clin Oncol. 2005;23(31):7897-903. doi: 10.1200/JCO.2004.00.6908.
  60. Rizzoli R, Body JJ, DeCensi A, Reginster JY, Piscitelli P, Brandi ML; European Society for Clinical and Economical aspects of Osteoporosis and Osteoarthritis (ESCEO). Guidance for the prevention of bone loss and fractures in postmenopausal women treated with aromatase inhibitors for breast cancer: an ESCEO position paper. Osteoporos Int. 2012;23(11):2567-76. doi: 10.1007/s00198-011-1870-0.
  61. Juozaitytė E, Aleknavičius E, Jančiauskienė R, Cesas A, Pipirienė-Želvienė T, Liutkauskienė S, Krasauskienė A, Vencevičienė L. Guidelines for diagnostics and treatment of aromatase inhibitor-induced bone loss in women with breast cancer: a consensus of Lithuanian medical oncologists, radiation oncologists, endocrinologists, and family medicine physicians. Medicina (Kaunas). 2014;50(4):197-203. doi: 10.1016/j.medici.2014.09.004.
  62. Gullberg B, Johnell O, Kanis JA. World-wide Projections for Hip Fracture. Osteoporosis Int. 1997;7(5):407-13.
  63. Hakim G, Volpin G. Surgical treatment of femoral neck fractures in young adults. Isr. Med. Assoc. J. 2015;17(6):380-2.
  64. Xiao Z, Ren D, Feng W, Chen Y, Kan W, Xing D. Height and risk of hip fracture: a meta-analysis of prospective cohort studies. Biomed Res Int. 2016;2016:2480693. doi: 10.1155/2016/2480693.
  65. Mitchell R, Harvey L, Brodaty H, Draper B, Close J. Hip fracture and the influence of dementia on health outcomes and access to hospital-based rehabilitation for older individuals. Disabil Rehabil. 2016 Nov;38(23):2286-95. doi: 10.3109/09638288.2015.1123306.
  66. Kim SH, Meehan JP, Blumenfeld T, Szabo RM. Hip fractures in the United States: 2008 nation wide emergency department sample. Arthritis Care Res (Hoboken). 2012;64(5):751-7. doi: 10.1002/acr.21580.
  67. Farouk O, Mahran DG, Said HG, Alaa MM, Eisa AA, Said GZ, Rashed H, Ez-Eldeen A. Hypovitaminosis D among patients admitted with hip fracture to a level-1 trauma center in the sunny Upper Egypt: prevalence and associated correlates. Geriatr Orthop Surg Rehabil. 2016 Sep;7(3):148-52. doi: 10.1177/2151458516655436.
  68. Chang KP, Center JR, Nguyen TV, Eisman JA. Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2004;19(4):532-6. doi: 10.1359/JBMR.040109.
  69. Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P 3rd, Obremskey W, Koval KJ, Nork S, Sprague S, Schemitsch EH, Guyatt GH. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. J Bone Joint Surg Am. 2003;85-A(9):1673-81.
  70. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C; IOF Working Group on Epidemiology and Quality of Life. A systematic review of Hip Fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012:23(9):2239-56. doi: 10.1007/s00198-012-1964-3.
  71. de Laet C, Kanis JA, Oden A, et al. Body mass index as predictor of fracture risk: a meta-analysis. Osteoporosis Int. 2005;16(11):1330-8. doi: 10.1007/s00198-005-1863-y.
  72. Johansson H, Kanis JA, Odén A, et al. Meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res. 2014;29(1):223-33. doi: 10.1002/jbmr.2017.
  73. Gralow JR, Biermann JS, Farooki A, Fornier MN, Gagel RF, Kumar R, Litsas G, McKay R, Podoloff DA, Srinivas S, Van Poznak CH. NCCN Task Force Report: Bone Health In Cancer Care. J Natl Compr Canc Netw. 2013 Aug;11 Suppl 3:S1-50; quiz S51.
  74. Tang X, Liu G, Kang J, Hou Y, Jiang F, Yuan W, Shi J. Obesity and risk of hip fracture in adults: a meta-analysis of prospective cohort studies. PLoS One. 2013;8(4):e55077. doi: 10.1371/journal.pone.0055077.
  75. Swart E, Roulette P, Leas D, Bozic KJ, Karunakar M. ORIF or arthroplasty for displaced femoral neck fractures in patients younger than 65 years old: an economic decision analysis. J Bone Joint Surg Am. 2017;99(1):65-75. doi: 10.2106/JBJS.16.00406.
  76. Bang CS, Shin IS, Lee SW, Kim JB, Baik GH, Suk KT, Yoon JH, Kim YS, Kim DJ. Osteoporosis and bone fractures in alcoholic liver disease: a meta-analysis. World J Gastroenterol. 2015;21(13):4038-47. doi: 10.3748/wjg.v21.i13.4038.
  77. Panday K, Gona A, Humphrey MB. Medication-induced osteoporosis: screening and treatment strategie. Ther Adv Musculoskelet Dis. 2014;6(5):185-202. doi: 10.1177/1759720X14546350.
  78. Gardner S, Weaver MJ, Jerabek S, Rodriguez E, Vrahas M, Harris M. Predictors of early failure in young patients with displaced femoral neck fractures. J Orthop. 2014;12(2):75-80. doi: 10.1016/j.jor.2014.
  79. Bhattoa HP, Nagy E, More C, Kappelmayer J, Balogh A, Kalina E, Antal-Szalmas P. Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in healthy Hungarian men over 50 years of age: the Hun Men Study. Osteoporos Int. 2013;24(1):179-86. doi: 10.1007/s00198-012-1920-2.
  80. Lassemillante AC, Doi SA, Hooper JD, Prins JB, Wright OR. Prevalence of osteoporosis in prostate cancer survivors: a meta-analysis. Endocrine. 2014;45(3):370-81. doi: 10.1007/s12020-013-0083-z.
  81. Resnick MJ, Lacchetti C, Bergman J, et al. Prostate cancer survivorship care guideline: American Society of Clinical Oncology Clinical Practice Guideline endorsement. J Clin Oncol. 2015;33(9):1078-85. doi: 10.1200/JCO.2014.60.2557.
  82. Simonen O, Laitinen O. Does fluoridation of drinking-water prevent bone fragility and osteoporosis? Lancet. 1985;2:432-4.
  83. Stangelberger A, Waldert M, Djavan B. Prostate cancer in elderly men. Rev Urol Spring. 2008;10(2):111-9.
  84. Forsén L, Sogaard AJ, Meyer HE, Edna T, Kopjar B. Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int. 1999;10:73-8.
  85. Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL, Jones MP, Rosenthal GE, Wolinsky FD. The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol. 2009;170(10):1290-9. doi: 10.1093/aje/kwp266.
  86. Prieto-Alhambra D, Premaor MO, Fina Avilés F, Hermosilla E, Martinez-Laguna D, Carbonell-Abella C, Nogués X, Compston JE, Díez-Pérez A. The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res. 2012;27(2):294-300. doi: 10.1002/jbmr.1466.
  87. Amato L, Colais P, Davoli M, Ferroni E, Fusco D, Minozzi S, Moirano F, Sciattella P, Vecchi S, Ventura M, Perucci CA. Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data. Epidemiol Prev. 2013 Mar-Jun;37(2-3 Suppl 2):1-100.
  88. Wilkin TJ, Devendra D. Bone densitometry is not a good predictor of hip fracture. BMJ. 2001;323:795-9.
  89. Xiu B-H. Expert group consensus: prevention, diagnosis and treatment of bone loss and osteoporosis in postmenopausal breast cancer patients after aromatase inhibitor therapy. Zhonghua Zhong Liu Za Zhi. 2013;35(11):876-9.

How to Cite

Hurbanova, T., Babalyan, V., Cherepov, D., & Kalchenko, A. (2017). Cervical fractures of femoral bone in eldery patients: epidimeology and causative fractures (literature review). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 114–122. https://doi.org/10.15674/0030-598720173114-122

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