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Geriatric fracture

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https://www.readbyqxmd.com/read/28816875/controversies-in-the-management-of-geriatric-odontoid-fractures
#1
Scott C Wagner, Gregory D Schroeder, Christopher K Kepler, Alexander J Schupper, Frank Kandziora, Emiliano N Vialle, Cumhur Oner, Michael G Fehlings, Alexander R Vaccaro
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28803357/determinants-of-functional-outcome-in-hip-fracture-the-role-of-comorbidity
#2
Bernardo Gialanella, Paola Prometti, Vittoria Monguzzi, Cristina Ferlucci, Paola Baiardi, Laura Comini
BACKGROUND AND AIMS: Executed studies did not clearly identify which index of comorbidity was an independent outcome determinant. The aim of this prospective observational cohort study was to address this issue. METHODS: We analyzed 200 consecutive patients with hip fracture. All patients underwent rehabilitation. At admission comorbidity was assessed through the cumulative severity, severity index, and comorbidity index of the Cumulative Illness Rating Scale. Discharge scores and effectiveness in the Functional Independence Measure motor subscale, and discharge destination were the outcome measures...
August 12, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28795216/the-impact-of-pre-existing-conditions-on-functional-outcome-and-mortality-in-geriatric-hip-fracture-patients
#3
Christopher Bliemel, Benjamin Buecking, Ludwig Oberkircher, Matthias Knobe, Steffen Ruchholtz, Daphne Eschbach
PURPOSE: Due to pre-existing illnesses, elderly hip fracture patients represent a vulnerable patient population. The present study was conducted to investigate the effects of various pre-existing conditions on the outcomes of hip fracture patients. METHODS: A total of 402 surgically treated geriatric hip fracture patients were included in this prospective, single-centre study. Upon admission, patient age, gender and fracture type were documented, among other information...
August 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28776209/potentially-inappropriate-medications-and-the-time-to-full-functional-recovery-after-hip-fracture
#4
Andrea Iaboni, Kerri Rawson, Craig Burkett, Eric J Lenze, Alastair J Flint
BACKGROUND: Older adults after hip fracture are at increased risk of being prescribed potentially inappropriate medications, and may be particularly vulnerable to their adverse effects. OBJECTIVE: The objective of this study was to examine the association of potentially inappropriate medication use with the time to full functional recovery within 1 year of hip fracture repair. METHODS: We conducted a secondary analysis of a prospective longitudinal study of eight hospitals in St...
August 3, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28771952/prevalence-and-determinants-of-frailty-and-associated-comorbidities-among-older-gurkha-welfare-pensioners-in-nepal
#5
Sirjana Devkota, Bruce Anderson, Roy L Soiza, Phyo K Myint
AIM: Population aging is increasing in low-income countries. Despite this, there is distinct lack of knowledge about the prevalence of comorbidities and determinants of frailty among older people in these countries. METHODS: We examined data from "Health and Social Care Needs Assessment Survey of the Gurkha Welfare Pensioners" carried out in 2014. Participants were aged ≥60 years from the Gorakha, Lamjung and Tanahu districts of Nepal. Face-to-face interviews were carried out using validated questionnaires...
August 2, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28765416/the-physician-s-role-in-perioperative-management-of-older-patients-undergoing-surgery
#6
Adam L Gordon, Barry J Evans, Jugdeep Dhesi
Life-sustaining and life-improving surgical interventions are increasingly available to older, frailer patients, many of whom have multimorbidity. Physicians can help support perioperative multidisciplinary teams with assessment and preoperative optimisation of physiological reserve, comorbidities and associated geriatric syndromes. Similar structured support can be useful in the postoperative period where older patients are at increased risk of delirium, medical complications, increased functional dependency and where discharge planning can prove more difficult than in younger cohorts...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28756586/the-female-geriatric-proximal-humeral-fracture-protagonist-for-straight-antegrade-nailing
#7
Richard A Lindtner, Franz S Kralinger, Sebastian Kapferer, Clemens Hengg, Markus Wambacher, Simon A Euler
INTRODUCTION: Straight antegrade humeral nailing (SAHN) has become a standard technique for the surgical fixation of proximal humeral fractures, which predominantly affect elderly females. The nail's proximal anchoring point has been demonstrated to be critical to ensure reliable fixation in osteoporotic bone and to prevent iatrogenic damage to the superior rotator cuff bony insertion. Anatomical variations of the proximal humerus, however, may preclude satisfactory anchoring of the nail's proximal end and may bare the risk of rotator cuff violation, even though the nail is inserted as recommended...
July 29, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28755453/frailty-as-a-risk-factor-for-falls-among-community-dwelling-people-evidence-from-a-meta-analysis
#8
Mei-Hsun Cheng, Shu-Fang Chang
PURPOSE: This study was conducted to investigate the relationships between different frailty stages and the fall incidence rates of community-dwelling older adults. The differences between various frailty indicators regarding assessment accuracy of the fall incidence rates of community-dwelling elders were also analyzed. Finally, the relationship between frailty and recurrent falls was explored. METHODS: This study comprised a systematic literature review and meta-analysis...
July 29, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28752139/association-between-serum-vitamin-b12-level-and-frailty-in-older-adults
#9
Ozge Dokuzlar, Pinar Soysal, Ahmet Turan Isik
OBJECTIVE: Frailty is associated with recurrent falls, fractures, limitation of daily living activities, cognitive impairment, increase in hospitalization, placement in nursing home, and mortality rate in older adults. Although malnutrition is one of the most important etiological factors, role of micronutrients is unclear. The aim of this study was to investigate association between frailty and vitamin B12, which has been demonstrated to be related to numerous geriatric syndromes. METHODS: Total of 335 patients who presented at geriatric outpatient clinic and underwent comprehensive geriatric assessment were included in this study...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28742787/functional-outcomes-of-elderly-patients-with-nonoperatively-treated-acetabular-fractures-that-meet-operative-criteria
#10
Scott P Ryan, Theodore T Manson, Marcus F Sciadini, Jason W Nascone, Christopher T LeBrun, Renan C Castillo, Ragu Muppavarapu, Brian Schurko, Robert V O'Toole
OBJECTIVES: To report functional outcomes of displaced acetabular fractures treated nonoperatively in the geriatric patient population. DESIGN: Retrospective case series. SETTING: Two Level I trauma centers. PATIENTS: Twenty-seven patients age 60 years or older who sustained displaced acetabular fractures during an 11-year period. INTERVENTION: Nonoperative treatment. MAIN OUTCOME MEASUREMENTS: Primary outcome measurements were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Short Form 8 (SF-8) scores...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28740525/the-use-of-cholecalciferol-in-patients-with-hip-fracture
#11
Luisella Cianferotti, Simone Parri, Giorgio Gronchi, Roberto Civinini, Maria Luisa Brandi
INTRODUCTION: Major osteoporotic fractures are steadily increasing due to population aging. Programs of secondary prevention against refracture are essential to decrease morbidity and mortality and the cost for individuals and the society. Vitamin D supplementation and optimization of calcium intake are of a pivotal importance to start specific osteoporosis treatment and for its safety and efficacy. Cholecalciferol is the most widely employed drug for vitamin D supplementation. PURPOSE: Aim of this study was to assess the trends in the use of vitamin D supplements containing cholecalciferol in the population of hip fracture patients older than 65 years, resident in the region of Tuscany (Italy) in the years 2011-2015 and to describe vitamin D status in a subgroup of this individuals directly referred to a bone clinic for further evaluation after hip osteoporotic fracture...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#12
Nicholas B Antell, Julie A Switzer, Andrew H Schmidt
The incidence of acetabular fractures in the elderly population is increasing. Fractures in this population differ from those in younger patients, with more frequent involvement of the anterior column, more comminution, and more severe articular impaction in elderly patients. Although acetabular fractures in geriatric patients are more likely the result of low-energy trauma, outcomes are generally poorer than those in young patients. Multiple management options have been proposed, but no intervention has become the standard of care for these fractures in the elderly...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28733108/first-line-management-of-distal-humerus-fracture-by-total-elbow-arthroplasty-in-geriatric-traumatology-results-in-a-21-patient-series-at-a-minimum-2-years-follow-up
#13
D Lami, M Chivot, A Caubere, A Galland, J N Argenson
INTRODUCTION: Total elbow arthroplasty (TEA) is one option in distal humerus fracture in elderly osteoporotic patients. HYPOTHESIS: The study hypothesis was that, in patients aged 70 years or more,TEA provides functional results and ranges of motion compatible with everyday activity, with a complications rate equal to or lower than with internal fixation, and no loss of autonomy or cognitive impairment. MATERIALAND METHODS: In this retrospective study, 21 patients receiving TEA for distal humerus fracture were included...
July 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28719564/the-new-apgar-score-a-checklist-to-enhance-quality-of-life-in-geriatric-patients-with-hip-fracture
#14
Joseph Bernstein, Sara Weintraub, Eric Hume, Mark D Neuman, Stephen L Kates, Jaimo Ahn
For geriatric patients with hip fractures, the broken bone is the reason for admission, but only part of the overall disease. Indeed, it may be more helpful to consider the patient having geriatric hip fracture syndrome or sustaining a hip attack, as there are many associated medical, social, psychological, and other problems to which attention must be paid. To that end, we have identified a series of 10 steps, collected into a checklist, that can be undertaken for all patients with geriatric hip fracture. In homage to the maxim "we come into the world under the brim of the pelvis and go out through the neck of the femur," we defined our checklist by the acronym APGAR SCORE, named after the classic checklist of the same name used to assess a newborn child...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28718704/a-study-of-sports-related-orbital-fractures-in-singapore
#15
Jing Zhan Lock, Raghuraj Hegde, Stephanie Young, Thiam Chye Lim, Shantha Amrith, Gangadhara Sundar
With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27...
July 18, 2017: Orbit
https://www.readbyqxmd.com/read/28713653/frail-phenotype-might-herald-bone-health-worsening-among-end-stage-renal-disease-patients
#16
Chia-Ter Chao, Jenq-Wen Huang, Ding-Cheng Chan
BACKGROUND: Frailty exhibits a high prevalence in end-stage renal disease (ESRD) patients and is associated with adverse health-related outcomes, including falls and fractures. Available studies do not address whether frailty is associated with temporal changes in BMD. We evaluated this issue by analyzing the follow-up dual energy X-ray absorptiometry (DXA) results in an ESRD cohort. METHODS: In 2015, we enrolled forty-three ESRD patients, divided into frail, pre-frail, and robust ones based on a validated simple FRAIL scale, all receiving DXA at baseline...
2017: PeerJ
https://www.readbyqxmd.com/read/28712980/association-of-selective-serotonin-reuptake-inhibitors-and-bone-mineral-density-in-elderly-women
#17
Smita Saraykar, Vineeth John, Bo Cao, Matthew Hnatow, Catherine G Ambrose, Nahid Rianon
Depression and osteoporosis are 2 common comorbidities in geriatric patients. There are concerns about the deleterious effects of selective serotonin reuptake inhibitor (SSRI) antidepressant use on bone mineral density (BMD). We examined the association between SSRI use and BMD in elderly women (≥65 yr) referred to a geriatric osteoporosis clinic for bone health evaluation. Cross-sectional analyses using the general linear model were performed on data collected retrospectively from August 2010 to April 2015...
July 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28708309/bone-healing-in-an-aged-murine-fracture-model-is-characterized-by-sustained-callus-inflammation-and-decreased-cell-proliferation
#18
John H Hebb, Jason W Ashley, Lee McDaniel, Luke A Lopas, John Tobias, Kurt D Hankenson, Jaimo Ahn
Geriatric fractures take longer to heal and heal with more complications than those of younger patients; however, the mechanistic basis for this difference in healing is not well understood. To improve this understanding, we investigated cell and molecular differences in fracture healing between 5 month-old (young adult) and 25 month-old (geriatric) mice healing utilizing high-throughput analysis of gene expression. Mice underwent bilateral tibial fractures and fracture calluses were harvested at 5, 10, and 20 days post fracture (DPF) for analysis...
July 14, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28707364/furosemide-use-and-acute-risk-of-hip-fracture-in-older-people-a-nationwide-case-control-study-in-taiwan
#19
Shih-Wei Lai, Kao-Chi Cheng, Cheng-Li Lin, Kuan-Fu Liao
AIM: Little is known about the acute effects of furosemide use on the risk of hip fracture. The aim of the present study was to evaluate the association between furosemide use and acute risk of hip fracture in older people in Taiwan. METHODS: We carried out a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. A total of 4523 older adults aged ≥65 years with newly diagnosed hip fracture from 2000 to 2013 were identified as the cases...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28707131/posterior-locked-lateral-compression-injury-of-the-pelvis-in-geriatric-patients-an-infrequent-and-specific-variant-of-the-fragility-fracture-of-pelvis
#20
Se-Won Lee, Weon-Yoo Kim, Sung-Jun Koh, Young-Yul Kim
INTRODUCTION: Posterior locked lateral compression injury (PLLCI) of the pelvic ring is an infrequent variant of lateral compression injury, a condition described in only eight reported cases since 2000. Lateral compression injury usually results from high-energy trauma and is characterized by locking between the medially translated fractured ilium and the anterior border of the sacrum, regardless of whether the fractured ilium involves the sacroiliac joint. However, in our experience, lateral compression injury can also result from low-energy trauma as a manifestation of pelvic fragility fracture...
July 13, 2017: Archives of Orthopaedic and Trauma Surgery
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