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Geriatric Orthopaedic Surgery & Rehabilitation

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https://www.readbyqxmd.com/read/28255514/initial-preoperative-management-of-geriatric-hip-fractures
#1
REVIEW
Tochukwu C Ikpeze, Stephen Mohney, John C Elfar
Hip fractures are a common emergency among the geriatric population and often requires immediate hospitalization for proper assessment. More than 90% of the time, hip fractures are suffered by individuals older than 65 and are usually precipitated predominantly by falls. Current studies show that the average individual over 65 years falls at least once a year, and roughly 1 out of every 4 of these individuals succumb to their injuries just 12 months following surgical treatment. Moreover, timely treatment and management of these hip fractures have shown to decrease mortality by reducing cardiopulmonary and venous thromboembolic complications that often accompany hip surgeries...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255513/indications-for-direct-laryngoscopic-examination-of-vocal-cord-function-prior-to-anterior-cervical-surgery
#2
REVIEW
Anirudh Gowd, Alireza Nazemi, Jonathan Carmouche, Todd Albert, Caleb Behrend
Recurrent laryngeal nerve palsy (RLNP) is among the most common complications in both thyroid surgeries and anterior approaches to the cervical spine, having both a diverse etiology and presentation. Most bilateral paresis, with subsequent devastating impact on patients, are due to failure to recognize unilateral recurrent laryngeal nerve paralysis and, although rare, are entirely preventable with appropriate history and screening. Recurrent laryngeal nerve palsy has been shown to present asymptomatically in as high as 32% of cases, which yields limitations on exclusively screening with physical examination...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255512/seasonal-variation-in-hip-fracture-mortality
#3
Dennis K H Yee, Christian Fang, T W Lau, Terence Pun, T M Wong, Frankie Leung
OBJECTIVES: This study aims to identify if wintertime surgery increases the mortality of the patients after hip fracture operations. DESIGN: Retrospective observational cohort study. SETTING: The data for this citywide retrospective observational cohort study came from Clinical Data Analysis Reporting System. PATIENT: This study included 35 409 patients with hip fracture operations from July 2005 to December 2013. MAIN OUTCOME MEASURES: Cox regression hazard model was used to estimate the independent effect of operation being performed in winter on the hazard of mortality...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255511/can-direct-current-electrotherapy-be-used-for-patients-with-orthopedic-implants
#4
Evangeline Thaler, Felippe Toledo, Holger Korte
INTRODUCTION: Although electrotherapy appears to have particularly interesting applications in the field of postoperative orthopedic rehabilitation, relatively little scientifically based research has been conducted in the area of electrotherapy with regard to safety involving patients with orthopedic implants. METHOD: Three electrotherapy forms were tested, such as high-volt stimulation (HVS), transcutaneous electric nerve stimulation (TENS), and galvanic current (GAL), using a model system containing a metal implant plate to evaluate whether heating in excess of 3°C would occur...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255510/risk-factors-for-urinary-retention-following-surgical-repair-of-hip-fracture-in-female-patients
#5
Ron Cialic, Victor Shvedov, Yaffa Lerman
BACKGROUND/OBJECTIVES: Postoperative urinary retention (POUR) is a common event following surgical procedures. An increase in the number of elderly individuals who undergo hip fracture repair procedures is inevitable due to the aging of population. Postoperative urinary retention is associated with both early (infections, delirium) and late complications (urinary incontinence) of surgery. The objective of the current study is to direct attention to the less studied population of patients admitted to a geriatric rehabilitation ward following hip fracture repair who are at risk of POUR...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255509/palliative-management-of-nonoperative-femoral-neck-fractures-with-continuous-peripheral-pain-catheters-20-patient-case-series
#6
Christopher H Rashidifard, Nicholas M Romeo, Paul Muccino, Mark Richardson, Thomas G DiPasquale
INTRODUCTION: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. METHODS: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255508/early-complications-following-osteosynthesis-of-distal-radius-fractures-a-comparison-of-geriatric-and-nongeriatric-cohorts
#7
Richard M Hinds, John T Capo, Sanjeev Kakar, James Roberson, Michael B Gottschalk
BACKGROUND: Distal radius fractures (DRFs) are common geriatric fractures with the overall incidence expected to increase as the population continues to age. The purpose of this investigation was to compare the short-term complication rates in geriatric versus nongeriatric cohorts following osteosynthesis of DRFs. METHODS: The American Board of Orthopaedic Surgery (ABOS) part II database was queried for adult DRF cases performed from 2007 to 2013. Current Procedural Terminology codes were used to identify cases treated via osteosynthesis...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255507/the-effect-of-insurance-type-on-fragility-fracture-patient-access-to-endocrinology-under-the-affordable-care-act
#8
Daniel H Wiznia, Sifon Ndon, Chang-Yeon Kim, Theodore Zaki, Michael P Leslie
OBJECTIVES: To assess the effect of insurance type (Medicaid, Medicare, and private insurance) on fragility fracture patients' access to endocrinology specialists in the postoperative period. MATERIALS AND METHODS: The research team called 247 board-certified endocrinologists in 8 representative states. The caller requested an appointment for her fictitious mother to be evaluated for osteoporosis after suffering a hip fracture that required surgery. The caller stated that her mother had an abnormal level of parathyroid hormone and her mother's orthopedic surgeon believed she needed to see an endocrinologist...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255506/spinal-epidural-hematoma-related-to-vertebral-fracture-in-an-atypical-rigid-diffuse-idiopathic-skeletal-hyperostosis-a-case-report
#9
José Ramírez Villaescusa, Marcela Restrepo Pérez, David Ruiz Picazo
INTRODUCTION: Spinal epidural hematoma (SEH) is a rare disease that causes cord compression and neurologic deficit. Spontaneous SEH is related to minor trauma, bleeding disorders, and anticoagulant medications. Posttraumatic SEH has been associated with low-energy spine hyperextension injuries in patients with ankylosing spinal disorders such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). A variant named atypical DISH-like with SEH is reported. OBJECTIVE: To describe the management, diagnosis, and treatment of an unusual SEH case in a patient causing delayed neurologic deficit with rigid atypical DISH-like spine...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255505/odontoid-fracture-in-a-patient-with-diffuse-idiopathic-skeletal-hyperostosis
#10
Adan Omar, Addisu Mesfin
Nonoperative management of fractures in the setting of diffuse idiopathic skeletal hyperostosis (DISH) or ankylosing spondylitis is often unsuccessful. The subaxial spine is a common site of hyperextension fractures in the setting of DISH. Fractures of the upper cervical spine are uncommon in DISH. We report, to our knowledge, the first case describing successful nonoperative management of a type 2 odontoid fracture in a patient with DISH. We discuss the patient's initial presentation, physical examination, imaging findings, and management...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255504/usefulness-of-urinoculture-to-patients-with-dementia-and-femoral-neck-fracture-at-admission-to-hospital-preliminary-results
#11
Laura Garcia-Nuño, Carlos Villamil, Araceli González-Cuevas, David Martí, Silvia Capilla, Maria José Vives, Xavier Oncins, Pere Torner, Juan Castellanos, Lluís Font-Vizcarra
INTRODUCTION: While preoperative urinary tract infection (UTI) has the potential to cause bacteremia and postsurgical acute prosthetic joint infections (APJIs), the influence of asymptomatic bacteriuria (AB) in these infections remains unclear. So the majority of guidelines not recommend the treatment of AB prior to the surgery. However, as patients with dementia usually cannot explain the symptoms of dysuria, the differential diagnosis between AB and UTI may be very difficult in this group of patients...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28255503/outcome-and-2-year-survival-rate-in-elderly-patients-with-lateral-compression-fractures-of-the-pelvis
#12
Andreas Höch, Orkun Özkurtul, Philipp Pieroh, Christoph Josten, Jörg Böhme
INTRODUCTION: Osteoporotic pelvic ring fractures are a rising problem for surgeons in industrialized countries. There is no evidence-based treatment strategy especially for lateral compression (LC) fractures involving the sacrum. The aim of this study was to evaluate and compare outcome and survival rate of nonoperative and operative treatment strategies for lateral compression fractures. PATIENTS AND METHODS: In a retrospective study, 128 patients (aged ≥65 years) with an Orthopedic Trauma Association (OTA) types B2...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/27847680/distal-radius-fracture-outcomes-and-rehabilitation
#13
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
https://www.readbyqxmd.com/read/27847679/opioid-usage-during-admission-in-hip-fracture-patients-the-effect-of-the-continuous-femoral-nerve-block
#14
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
https://www.readbyqxmd.com/read/27847678/a-systematic-review-of-treatment-strategies-for-degenerative-lumbar-spine-fusion-surgery-in-patients-with-osteoporosis
#15
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
https://www.readbyqxmd.com/read/27847677/the-use-of-moca-and-other-cognitive-tests-in-evaluation-of-cognitive-impairment-in-elderly-patients-undergoing-arthroplasty
#16
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
https://www.readbyqxmd.com/read/27847676/retentive-cup-arthroplasty-in-selected-hip-fracture-patients-a-prospective-series-with-a-minimum-3-year-follow-up
#17
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
https://www.readbyqxmd.com/read/27847675/an-orthopedic-hospitalist-comanaged-hip-fracture-service-reduces-inpatient-length-of-stay
#18
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
https://www.readbyqxmd.com/read/27551576/management-of-life-threatening-arterial-hemorrhage-following-a-fragility-fracture-of-the-pelvis-in-the-anticoagulated-patient-case-report-and-review-of-the-literature
#19
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
https://www.readbyqxmd.com/read/27551575/patients-with-multiple-myeloma-have-more-complications-after-surgical-treatment-of-hip-fracture
#20
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
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