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Geriatric Orthopaedic Surgery & Rehabilitation

Tochukwu C Ikpeze, Heather C Smith, Daniel J Lee, John C Elfar
Distal radius fractures account for nearly 1 of every 5 fractures in individuals aged 65 or older. Moreover, increased susceptibility to vertebral and hip fractures has been documented in patients a year after suffering a distal radius fracture. Although women are more susceptible to hip fractures, men experience a higher mortality rate in the 7 years following a distal radius fracture. Traditional approaches to distal radius fractures have included both surgical and nonsurgical treatments, with predominant complaints involving weakness, stiffness, and pain...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Ida Helsø, Christopher Jantzen, Jes Bruun Lauritzen, Henrik Løvendahl Jørgensen
INTRODUCTION: The aim of this study was to investigate whether there was a difference in opioid usage during admission for hip fracture patients with continuous femoral nerve block (cFNB) when compared to patients nonfemoral nerve block (nFNB). METHODS AND MATERIALS: Patients were identified from the local database on all hip fracture patients admitted to Bispebjerg University Hospital, Denmark. Four hundred fifty-six hip fracture patients were included during the period September 2008 to October 2010...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Charla R Fischer, Gregory Hanson, Melinda Eller, Ronald A Lehman
PURPOSE: To evaluate the current evidence in the literature on treatment strategies for degenerative lumbar spine fusion in patients with osteoporosis. METHODS: A systematic review of the literature from 1950 to 2015. RESULTS: The review of the literature yielded 15 studies on the effect of treatment options for osteoporosis on lumbar fusion rates. This study evaluated only degenerative lumbar spine conditions and excluded deformity patients...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Jukka Puustinen, Liisa Luostarinen, Markku Luostarinen, Veijo Pulliainen, Heini Huhtala, Marjo Soini, Jaana Suhonen
OBJECTIVE: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. MATERIALS AND METHODS: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Mustafa Yassin, Avraham Garti, Muhammad Khatib, Moshe Weisbrot, Dror Robinson
OBJECTIVE: To evaluate the efficacy of the use of retentive cup primary total hip replacement (THR) in high-dislocation risk subcapital fracture patients. METHODS: During the years 2008 to 2012, 354 patients with displaced subcapital fracture were operated at our institute. The patients were selected to undergo primary constrained THR according to the following criteria: (1) a preinjury grade 4 or more on the Functional Independence Measure mobility item "5. Locomotion: walking/wheelchair" and grade 4 is defined as "4...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Daniel N Bracey, Tunc C Kiymaz, David C Holst, Kamran S Hamid, Johannes F Plate, Erik C Summers, Cynthia L Emory, Riyaz H Jinnah
INTRODUCTION: Hip fractures are common in the elderly patients with an incidence of 320 000 fractures/year in the United States, representing a health-care cost of US$9 to 20 billion. Hip fracture incidence is projected to increase dramatically. Hospitals must modify clinical models to accommodate this growing burden. Comanagement strategies are reported in the literature, but few have addressed orthopedic-hospitalist models. An orthopedic-hospitalist comanagement (OHC) service was established at our hospital to manage hip fracture patients...
December 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Christian David Weber, Christian Herren, Thomas Dienstknecht, Frank Hildebrand, Sebastian Keil, Hans-Christoph Pape, Philipp Kobbe
BACKGROUND: Life-threatening arterial bleeding from fragility fractures of the pelvis are very rare but associated with significant mortality, especially in anticoagulated patients. CASE DESCRIPTION: We report the successful interdisciplinary management of a 78-year-old woman under anticoagulation and antiplatelet therapy who had life-threatening arterial hemorrhage from the pubic rami following a fragility fracture of the pelvis. Our management strategy included early hemorrhage control by means of selective arterial embolization followed by surgical fracture stabilization and surgical hematoma evacuation...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Kwan Jun Park, Mariano E Menendez, Simon C Mears, C Lowry Barnes
OBJECTIVES: Bone lesions from multiple myeloma may lead to pathological fracture of the proximal femur, requiring either fixation or arthroplasty. Little is known about the impact of multiple myeloma on hip fracture care. We investigated whether the patients with multiple myeloma undergoing surgical treatment of hip fractures would be at increased risk for adverse outcomes versus patients who sustain a hip fracture without multiple myeloma. METHODS: Using discharge records from the Nationwide Inpatient Sample (2002-2011), we identified 2 440 513 patients older than 50 years of age with surgically treated hip fractures...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Valentinas Uvarovas, Igoris Šatkauskas, Robertas Urbonavičius, Vytautas Bučinskas, Julius Griškevičius, Vytautas Vengrauskas, Giedrius Petryla, Povilas Masionis, Audrius Andrijauskas, Narūnas Porvaneckas
INTRODUCTION: The total hip arthroplasty (THA) as part of acute fracture management is used for acetabular fractures in elderly patients. Our objective was to assess the stability of osteosynthesis performed using 2 different techniques in combination with THA in an experimental model. MATERIALS AND METHODS: We conducted 20 experiments using the left-side hemipelves composite bone models. There were 2 testing groups: 1- and 2-stage osteosynthesis. The acetabular fractures of the anterior column and posterior hemitransverse were simulated...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Osama Farouk, Dalia G Mahran, Hatem G Said, Mohamed M Alaa, Amr Atef Eisa, Galal Z Said, Heba Rashed, Azza Ez-Eldeen
INTRODUCTION: Despite abundant sunshine, hypovitaminosis D is common in the Middle East. The aim of this study was to determine the prevalence of hypovitaminosis D and related correlates among patients with hip fracture in Assiut University Hospitals in Upper Egypt. MATERIALS AND METHODS: A cross-sectional study was carried out in 133 patients with hip fracture, aged 50 years and older, admitted to Trauma Unit of Assiut University Hospitals, from January through December 2014...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Timothy L Kahn, Ran Schwarzkopf
BACKGROUND: Despite the alleviation of osteoarthritis (OA) symptoms that total knee arthroplasty (TKA) provides for patients with end-stage knee OA, recent studies have suggested that TKA may not increase physical activity levels. In this study, we compare the physical activity levels of patients with OA treated nonoperatively (non-TKA) with both patients who had received TKA (post-TKA) and patients who received TKA within 3 years of data collection (pre-TKA). METHODS: Utilizing the Osteoarthritis Initiative database, accelerometry data were collected from non-TKA, pre-TKA, and post-TKA patients...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Julius Bishop, Arthur Yang, Michael Githens, Alex H S Sox
BACKGROUND: Recent evidence supports total hip arthroplasty (THA) as compared to hemiarthroplasty (HA) for the management of displaced femoral neck fractures in a significant subset of elderly patients. The purpose of this study was to examine trends in femoral neck fracture management over the last 12 years. METHODS: Using the National Inpatient Sample database, we identified patients treated for femoral neck fractures between 1998 and 2010 with THA, HA, or internal fixation (IF)...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Joshua C Rozell, Krishna C Vemulapalli, Joshua L Gary, Derek J Donegan
Tibial plateau fractures are common in the elderly population following a low-energy mechanism. Initial evaluation includes an assessment of the soft tissues and surrounding ligaments. Most fractures involve articular depression leading to joint incongruity. Treatment of these fractures may be complicated by osteoporosis, osteoarthritis, and medical comorbidities. Optimal reconstruction should restore the mechanical axis, provide a stable construct for mobilization, and reestablish articular congruity. This is accomplished through a variety of internal or external fixation techniques or with acute arthroplasty...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Javier Benchimol, Fernando Fiorentini, Cristina M Elizondo, Bruno R Boietti, Guido Carabelli, Jorge Barla, Carlos Sancineto, Gabriel D Waisman, Diego H Giunta
BACKGROUND: A clinical registry encompasses a selective set of rigorously collected and stored clinical data focused on a specific condition. Hip fracture is a common complication of osteoporosis in elderly patients. Hip fracture substantially increases the risk of death and major morbidity in the elderly patients. Limited data regarding hip fracture are available from Latin America and Argentina. The purpose of this project is to create an institutional registry of elderly patients with hip fracture in order to obtain data that reveal the impact of this disease in our environment, allowing us to evaluate different strategies of patient's care and clinical outcomes...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Katrine Praetorius, Christian M Madsen, Bo Abrahamsen, Henrik L Jørgensen, Jes B Lauritzen, Anne Sofie B Laulund
INTRODUCTION: Previous smaller studies suggest that anemia is a risk factor for mortality in patients with hip fracture. The purpose of this investigation was to assess the correlation between hemoglobin at admission with 30-day mortality following a hip fracture in a large-scale study. PATIENTS AND METHODS: From January 1996 to December 2012, all patients with hip fracture (>60 years of age) admitted to Bispebjerg Hospital, Copenhagen, were identified from a local hip fracture database...
September 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Gerard Markey, Noel Reilly, Paul Kelly, Conor Kelly
No abstract text is available yet for this article.
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Tochukwu C Ikpeze, John C Elfar
The increase in the growth of the elderly population in the past 2 decades has been paralleled by an increase in the number of active elderly drivers. Consequentially, this growth has been accompanied by a rise in fatal road-related accidents. Due to age-related fragility, elderly drivers are more susceptible to injuries and death following a road-related accident. The increased risk of accidents has become a growing public health issue and has led to certain guidelines and restrictions for elderly drivers...
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Paul Rizk, William Morris, Philip Oladeji, Michael Huo
Postoperative delirium is a serious complication following hip surgery in elderly patients that can adversely affect outcomes in both hip fracture and arthroplasty surgery. Recently, the incidence of hip fracture in the Medicare population was estimated at approximately 500 000 patients per year, with the majority treated surgically. The annual volume of total hip arthroplasty is nearly 450 000 patients and is projected to increase over the next 15 to 20 years. Subsequently, the incidence of postoperative delirium will rise...
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Ran Schwarzkopf, Jenny Ho, John R Quinn, Nimrod Snir, Dana Mukamel
INTRODUCTION: The demand for total knee arthroplasty (TKA) continues to challenge hospital financial resources. Hospitals have countered this economic demand by reducing patient length of stay (LoS), thus requiring a higher utilization of extended care facilities (ECF) and home with home health care (HHC). With an increase in the number of insured low-income families following the Affordable Care Act (ACA), TKA patients' demographics are anticipated to change. Both trends have significant economic implications, and predicting the discharge destinations of TKA patients would help plan for future health expenditures...
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
Marcia Uchoa de Rezende, Marcelo Issao Hissadomi, Gustavo Constantino de Campos, Renato Frucchi, Alexandre Felício Pailo, Thiago Pasqualin, Nadia Lucila Rocha Brito, Olga Fugiko Magashima Santana, Merilu Marins Moreira, Carolina Guimarães Strutz, Natalia Beraldo Dos Santos Matos, Olavo Pires de Camargo, Arnaldo José Hernandez
INTRODUCTION: Knee osteoarthritis (KOA) is the most prevalent form of osteoarthritis. Low socioeconomic level, age, and obesity are directly correlated with the incidence of the disease. Education, exercise, and diet are the core recommendations of all KOA treatment guidelines. OBJECTIVE: To evaluate the impact of a multiprofessional educational program on patients with KOA. METHODS: Of a total of 198 participants, 150 patients with KOA attended 2 days of lectures (at 1- to 3-month intervals) and received educational material on osteoarthritis, and a control group (48 patients) received educational materials only...
June 2016: Geriatric Orthopaedic Surgery & Rehabilitation
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