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Geriatric Orthopaedic Surgery & Rehabilitation

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https://www.readbyqxmd.com/read/29318091/nerve-blocks-in-the-geriatric-patient-with-hip-fracture-a-review-of-the-current-literature-and-relevant-neuroanatomy
#1
REVIEW
Nirav H Amin, Jacob A West, Travis Farmer, Hrayr G Basmajian
Introduction: Hip fracture is a common occurrence in the elderly population with high morbidity and mortality due to postoperative pain and opioid use. The goal of this article is to review the current literature on the neuroanatomy of the hip and the use of localized nerve block in controlling hip fracture pain. Methods: A thorough search of MEDLINE/PubMed, Embase, and the Cochrane Database of Systematic Reviews was conducted using the search terms "hip fracture" and "fascia iliaca block (FICB)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318090/c1-2-fixation-approach-for-patients-with-vascular-irregularities-a-case-report
#2
Alireza K Nazemi, Stetson R Bickley, Caleb J Behrend, Jonathan J Carmouche
In posterior spinal fusion (PSF), the vertebral artery is most vulnerable to injury at C1-2. C2 pedicle screws are often placed into the dorsomedial isthmus of C2. Alternative techniques include C2 laminar screws and wiring techniques. A 67-year-old male underwent PSF for persistent severe intractable neck pain and degeneration at C1-2. The patient had an enlarged left vertebral artery with midline migration into the C2 body. This pattern was within one standard deviation of normal; however, it rendered typical placement of a C2 pedicle screw unsafe...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318089/falls-cognitive-function-and-balance-profiles-of-singapore-community-dwelling-elderly-individuals-key-risk-factors
#3
Mei Teng Woo, Keith Davids, Jarmo Liukkonen, Jia Yi Chow, Timo Jaakkola
Objective: This study compared occurrence of falls, cognitive function, and balance profiles across participants in elderly age categories, investigating associations between the 3 aspects in a sample of Singapore's elderly population. Method: Community-dwelling elderly individuals (N = 385) were randomly recruited and grouped into "young-old (65-74 years)," "medium-old (75-84 years)," and "oldest-old (above 85 years)" groups. The Fallproof Health and Activity questionnaire, adapted Mini-Mental State Examination (MMSE), and Berg Balance Scale (BBS) tests were used to survey information related to falls, cognition, and balance profiles...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#4
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318087/treatment-with-helical-blade-cephalomedullary-nail-for-two-part-basicervical-proximal-femoral-fracture-in-elderly-patients-a-retrospective-observational-study
#5
Ichiro Okano, Takatoshi Sawada, Nobumasa Kushima, Tetsuya Tachibana, Katsunori Inagaki
Background: Basicervical proximal femoral fracture is a known subtype of extracapsular fracture and is mechanically unstable, especially for the rotational direction, which may lead to implant failure. A cephalomedullary nail (CMN) is widely used for the fixation of unstable extracapsular fracture; however, its application for basicervical fracture remains controversial. Helical blade CMN is proven to have more rotational stability than traditional lag screw implants and potentially advantageous in the treatment of basicervical fracture...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318086/putting-the-brakes-on-breaks-osteoporosis-screening-and-fracture-prevention
#6
Sarah C Goode, Jacqueline L Beshears, Russell D Goode, Theresa F Wright, Anita King, Brett D Crist
Introduction: This prospective study sought to implement a screening tool to identify and risk stratify at-risk patients for osteoporosis and evaluate patient knowledge of osteoporosis and fragility fractures in an orthopedic trauma clinic affiliated with a level 1 trauma academic center. Methods: Of 297 eligible patients, 291 were screened and risk stratified. Patients completed an osteoporosis screening questionnaire and were risk stratified. Lifestyle advice was given to patients at low fracture risk...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318085/exploring-older-adult-ed-fall-patients-understanding-of-their-fall-a-qualitative-study
#7
Kalpana N Shankar, Devon Taylor, Caroline T Rizzo, Shan W Liu
Objective: We sought to understand older patients' perspectives about their fall, fall risk factors, and attitude toward emergency department (ED) fall-prevention interventions. Methods: We conducted semistructured interviews between July 2015 and January 2016 of community-dwelling, nondemented patients in the ED, who presented with a fall to an urban, teaching hospital. Interviews were halted once we achieve thematic saturation with the data coded and categorized into themes...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#8
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318083/a-missed-opportunity-in-bone-health-vitamin-d-and-calcium-use-in-elderly-femoral-neck-fracture-patients-following-arthroplasty
#9
Sheila Sprague, Kim Madden, Gerard Slobogean, Brad Petrisor, Jonathan D Rick Adachi, Earl Bogoch, Ydo V Kleinlugtenbelt, Mohit Bhandari
Introduction: Introduction: Adequate calcium and vitamin D from diet and supplementation is recommended for elderly hip fracture patients. Using data from the multinational hip fracture arthroplasty trial (HEALTH), we determined the proportion of patients who consistently took vitamin D and calcium and which characteristics/prescribing practices were associated with consistency of supplement use. Methods: HEALTH is a multicenter randomized trial of elderly hip fracture patients treated with hemi-arthroplasty and total hip arthroplasty...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318082/a-review-of-a-workers-compensation-database-2003-to-2013-patient-factors-influencing-return-to-work-and-cumulative-financial-claims-after-rotator-cuff-repair-in-geriatric-workers-compensation-cases
#10
Edward Shields, Caroline Thirukumaran, Katia Noyes, Ilya Voloshin
Background: Workers' compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers' compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques. Methods: An all workers' compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#11
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318080/race-and-rehabilitation-destination-after-elective-total-hip-arthroplasty-analysis-of-a-large-regional-data-set
#12
Ernest R Vina, Michael J Kallan, Aliya Collier, Charles L Nelson, Said A Ibrahim
Background: Three-quarters of patients who undergo total hip replacement (THR) receive postsurgical rehabilitation care in an inpatient rehabilitation facility (IRF), a skilled nursing facility (SNF), or through a home health agency. The objectives of this study are to examine racial differences where THR recipients receive postsurgical rehabilitation care and determine whether discharge destination is associated with hospital readmission. Methods: Using the Pennsylvania Health Care Cost Containment Council database, we selected African American (AA) or white adults who underwent THR surgery (n = 68,016)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318079/the-effect-of-an-in-hospital-comprehensive-geriatric-assessment-on-short-term-mortality-during-orthogeriatric-hip-fracture-program-which-patients-benefit-the-most
#13
Hanna M Pajulammi, Harri K Pihlajamäki, Tiina H Luukkaala, Janne J Jousmäki, Pekka H Jokipii, Maria S Nuotio
Aims: To examine the association of patient-related factors with the effect of an in-hospital comprehensive geriatric assessment (CGA) on hip fracture mortality. Methods: Population-based, prospective data were collected on 1425 consecutive hip fracture patients aged ≥65 in a central hospital providing orthogeriatric service. Outcome was mortality at 1 month after hip fracture associated with receiving versus not receiving CGA. Results: Of the patients receiving CGA compared to those who did not, 8...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835875/hip-fractures-in-elderly-people-surgery-or-no-surgery-a-systematic-review-and-meta-analysis
#14
REVIEW
Cornelis L P van de Ree, Mariska A C De Jongh, Charles M M Peeters, Leonie de Munter, Jan A Roukema, Taco Gosens
INTRODUCTION: Increasing numbers of patients with hip fractures also have advanced comorbidities. A majority are treated surgically. However, a significantly increasing percentage of medically unfit patients with unacceptably high risk of perioperative death are treated nonoperatively. Important questions about patients' prefracture quality of life (QOL) and future perspectives should be asked before considering different treatment options to assess what kind of treatment is advisable in frail elderly high-risk patients with a hip fracture...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835874/testing-the-hip-abductor-muscle-strength-of-older-persons-using-a-handheld-dynamometer
#15
Daniel H Awwad, Jonathan D Buckley, Rebecca L Thomson, Matthew O'Connor, Tania A Carbone, Mellick J Chehade
OBJECTIVE: To investigate the reliability of a clinically applicable method of dynamometry to assess and monitor hip abductor muscle strength in older persons. DESIGN: Bilateral isometric hip abductor muscle strength measured with a handheld dynamometer, patients supine with the contralateral hip positioned directly against a wall for stabilization. Reliability determined by comparing intra-assessor and inter-assessor results and comparison to a criterion standard (stabilized dynamometer with patients in the standing position)...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835873/hip-fractures-in-centenarians-has-care-improved-in-the-national-hip-fracture-database-era
#16
Alastair G Dick, Dominic Davenport, Mohit Bansal, Therese S Burch, Max R Edwards
INTRODUCTION: The number of centenarians in the United Kingdom is increasing. An associated increase in the incidence of hip fractures in the extreme elderly population is expected. The National Hip Fracture Database (NHFD) initiative was introduced in 2007 aiming to improve hip fracture care. There is a paucity of literature on the outcomes of centenarians with hip fractures since its introduction. The aim of this study is to report our experience of hip fractures in centenarians in the era since the introduction of the NHFD to assess outcomes in terms of mortality, time to surgery, length of stay, and complications...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835872/disparities-in-total-hip-arthroplasty-versus-hemiarthroplasty-in-the-management-of-geriatric-femoral-neck-fractures
#17
Sean Dangelmajer, Arthur Yang, Michael Githens, Alex H S Harris, Julius A Bishop
INTRODUCTION: Recent clinical evidence suggests that total hip arthroplasty (THA) provides improved clinical outcomes as compared to hemiarthroplasty (HA) for displaced femoral neck fractures in elderly individuals. However, THA is still utilized relatively infrequently. Few studies have evaluated the factors affecting utilization and the role socioeconomics plays in THA versus HA. METHODS: In the United States, the National Inpatient Sample (NIS) database was used to identify patients treated surgically for femoral neck fracture, between 2009 and 2010...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835871/multimodal-pain-management-in-older-elective-arthroplasty-patients
#18
Elaine Brooks, Susan H Freter, Susan K Bowles, David Amirault
BACKGROUND: Pain management after elective arthroplasty in older adults is complicated due to the risk of undertreatment of postoperative pain and potential adverse effects from analgesics, notably opioids. Using combinations of analgesics has been proposed as potentially beneficial to achieve pain control with lower opioid doses. OBJECTIVE: We compared a multimodal pain protocol with a traditional one, in older elective arthroplasty patients, measuring self-rated pain, incidence of postoperative delirium, quantity and cost of opioid analgesics consumed...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835870/preoperative-factors-influencing-decision-between-hemiarthroplasty-and-total-hip-arthroplasty-in-femoral-neck-fractures-in-indian-patients-retrospective-single-center-study
#19
Prakash Selvam, Sivamurugan Soundarapandian, Ravisubramaniam Soundarapandian, Cheralathan Senguttuvan
INTRODUCTION: The percentage of elderly population is increasing worldwide, with increasing incidence of femoral neck fractures. An increasing trend of arthroplasty for femoral neck fracture is observed. We aim to retrospectively analyze the preoperative factors that seem to influence the decision between hemiarthroplasty and total hip arthroplasty for managment of the same. MATERIALS AND METHODS: Patients admitted with femoral neck fracture during January 2010 to March 2015 in our institute were included in the study...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28835869/comminuted-patella-fracture-in-elderly-patients-a-systematic-review-and-case-report
#20
Brent Matthews, Kaushik Hazratwala, Sergio Barroso-Rosa
OBJECTIVES: To review comminuted patella fracture in the elderly patients and examine the surgical options to avoid complications such as fixation failure and poor functional outcome. To provide an example of mesh augmentation in comminuted patella fracture in the elderly patients. DATA SOURCES: A literature review was conducted by the authors independently using Ovid, Medline, Cochrane, PubMed, and Clinical Key in English. We aimed to review data on patients older than 65 with comminuted patella fracture...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
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