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Geriatric fracture

Shu-Fang Chang
PURPOSE: We investigated the relationships among geriatric syndrome, physiological functions, and body composition in community-dwelling older people with varying nutritional statuses. Other factors correlated with nutritional status in community-dwelling older people were also explored. BACKGROUND: The World Health Organization has initiated preventive programs for addressing malnutrition. However, few studies have focused on the correlations among geriatric syndrome, physiological functions, and body composition in older people at risk of malnutrition...
October 25, 2016: Journal of Nursing Scholarship
Amrut Borade, Harish Kempegowda, Akhil Tawari, Michael Suk, Daniel S Horwitz
INTRODUCTION: Care gaps have been identified in the treatment of osteoporosis after the occurrence of a fragility hip fracture. HiROC (High Risk Osteoporosis Clinic) is a fracture liaison service implemented at our institution. In ProvenCare geriatric hip fracture care program at our institution pre-set orders for the inpatient HiROC consults were prescribed. We hypothesized that there will be a significant increase in the rate of enrollment of patients in the HiROC program after the integration of the pre-set orders...
October 17, 2016: Injury
Markus T Hongisto, Maria Nuotio, Tiina Luukkaala, Olli Väistö, Harri K Pihlajamäki
BACKGROUND: Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. METHODS: Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively...
October 22, 2016: BMC Musculoskeletal Disorders
David Sanders, Dianne Bryant, Christina Tieszer, Abdel Lawendy, Mark MacLeod, Steven Papp, Liew Allan, Viskontas Darius, Coles Chad, Gurr Kevin, Carey Tim, Gofton Wade, Bailey Chris, Bartley Debra, Andrew Trenholm, Stone Trevor, Leighton Ross, Julia Foxall, Mauri Zomar, Kelly Trask
OBJECTIVES: To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT). DESIGN: Prospective, randomized, multi-centre clinical trial SETTING:: Five level 1 trauma centresPatients/Participants: 249 patients aged 55 years or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months. INTERVENTION: Computer generated randomization to either IT (n=123) or SHS (n=126)...
September 30, 2016: Journal of Orthopaedic Trauma
Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
M Iki, Y Fujita, J Tamaki, K Kouda, A Yura, Y Sato, J S Moon, A Harano, K Hazaki, E Kajita, M Hamada, K Arai, K Tomioka, N Okamoto, N Kurumatani
: Frail elderly individuals have elevated risks of both fracture and mortality. We found that incident fractures were associated with an increased risk of death even after adjusting for pre-fracture frailty status as represented by physical performance tests and laboratory tests for common geriatric diseases in community-dwelling elderly Japanese men. INTRODUCTION: While fractures reportedly increase the risk of mortality, frailty may complicate this association, generating a false-positive result...
October 18, 2016: Osteoporosis International
Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Natalie Z Wong, Tony Rosen, Allen M Sanchez, Elizabeth M Bloemen, Kevin W Mennitt, Keith Hentel, Refky Nicola, Kieran Murphy, Veronica M LoFaso, Neal E Flomenbaum, Mark S Lachs
PURPOSE: Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification...
October 13, 2016: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
Aparna P Nanduri, Sally Fullman, Lori Morell, Steve Buyske, Mary L Wagner
BACKGROUND: Project Healthy Bones (PHB) is a 24-week, peer-led exercise and education program for older adults at risk of osteoporosis. METHOD: Residents from an assisted living and senior community program were enrolled after medical clearance. Participant demographics, geriatric fitness assessments, exercise logs, quizzes, and surveys were collected at baseline and 24 weeks. Data were analyzed using paired t tests and ANOVA of change scores for the pooled data within the R statistical environment...
October 11, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Andrew W Bodrogi, Robert Sciortino, David A Fitch, Wade Gofton
BACKGROUND: Femoral neck fractures are common injuries in the geriatric population associated with high morbidity and mortality rates. Studies have shown outcomes can be positively influenced by early postoperative mobilization. The supercapsular percutaneously assisted total hip (SuperPath) surgical technique has been shown to lead to early mobilization for osteoarthritic total hip replacement patients and as such has the potential to provide similar benefits in fracture patients. This manuscript provides a detailed description of this technique using hemiarthroplasty to treat femoral neck fractures and presents the first case series of this application...
October 12, 2016: Journal of Orthopaedic Surgery and Research
Tony Rosen, Elizabeth M Bloemen, Jasmin Harpe, Allen M Sanchez, Kevin W Mennitt, Thomas J McCarthy, Refky Nicola, Kieran Murphy, Veronica M LoFaso, Neal Flomenbaum, Mark S Lachs
OBJECTIVE: Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists...
October 12, 2016: AJR. American Journal of Roentgenology
Kilian Rapp, Johannes Ravindren, Clemens Becker, Ulrich Lindemann, Andrea Jaensch, Jochen Klenk
BACKGROUND: There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. METHODS: This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014...
October 7, 2016: BMC Geriatrics
Megan E Gornet, Michael P Kelly
Fractures of the second cervical vertebra (C2, axis) are common in adult spine surgery. Those fractures occurring in younger adult patients are often associated with high-energy mechanism trauma, resulting in a "Hangman's Fracture." Management of these fractures is often successful with nonoperative means, though surgery may be needed in those fractures with greater displacement and injury to the C2-C3 disc. Older patients are more likely to sustain fractures of the odontoid process. The evidence supporting surgical management of these fractures is evolving, as there may be a mortality benefit to surgery...
September 29, 2016: Current Reviews in Musculoskeletal Medicine
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
Steve W Parry, Harry Hill, Joanna Lawson, Nick Lawson, David Green, Heidi Trundle, Judith McNaught, Victoria Strassheim, Alma Caldwell, Richard Mayland, Phillip Earley, Peter McMeekin
National and international evidence and guidelines on falls prevention and management in community-dwelling elderly adults recommend that falls services should be multifactorial and their interventions multicomponent. The way that individuals are identified as having had or being at risk of falls in order to take advantage of such services is far less clear. A novel multidisciplinary, multifactorial falls, syncope, and dizziness service model was designed with enhanced case ascertainment through proactive, primary care-based screening (of individual case notes of individuals aged ≥60) for individual fall risk factors...
September 27, 2016: Journal of the American Geriatrics Society
D Eschbach, T Kirchbichler, T Wiesmann, L Oberkircher, C Bliemel, S Ruchholtz, B Buecking
BACKGROUND: Most studies focusing on improving the nutritional status of geriatric trauma patients exclude patients with cognitive impairment. These patients are especially at risk of malnutrition at admission and of worsening during the perioperative fasting period. This study was planned as a feasibility study to identify the difficulties involved in including this high-risk collective of cognitively impaired geriatric trauma patients. PATIENTS AND METHODS: This prospective intervention study included cognitively impaired geriatric patients (Mini-Mental State Examination <25, age >65 years) with hip-related fractures...
2016: Clinical Interventions in Aging
Avital Hershkovitz, Natalia Kornyukov, Shai Brill
PURPOSE: The study aimed at assessing the relationship between various Mini Mental State Examination (MMSE) subdomains and rehabilitation achievements in post-acute hip-fractured patients. METHOD: Six hundred and five hip-fractured patients admitted during 2010-2013 to a post-acute geriatric rehabilitation center were included in the study. Main outcome measures were the Functional Independence Measure (FIM) instrument, the motor FIM (mFIM), the Montebello Rehabilitation Factor Score (MRFS) on the mFIM and length of stay (LOS)...
September 27, 2016: Disability and Rehabilitation
René Aigner, Constantin Salomia, Philipp Lechler, Roman Pahl, Michael Frink
BACKGROUND: The incidence of geriatric ankle fractures has increased during the last few decades. In contrast to younger patients, increased complication rates have been observed. Thus, the goal of the present study was to identify risk factors for perioperative complications following open reduction and internal fixation of geriatric ankle fractures. METHODS: Two hundred thirty-seven patients over the age of 65 years (mean, 72.5 ± 6.1 years) treated for ankle fractures in our institution between 2004 and 2014 were included...
September 23, 2016: Foot & Ankle International
Rishin J Kadakia, Briggs M Ahearn, Shay Tenenbaum, Jason T Bariteau
: Introduction Ankle fractures are the third most common orthopaedic injury seen in the geriatric patient. Studies have identified mortality benefits with operative management, but treatment must be considered on a case-by-case basis. In the era of value-based analysis, a thorough of understanding of outcomes and costs of treatment is required. The purpose of this study was to analyze the inpatient and readmission costs associated with operative and nonoperative management of geriatric ankle fractures...
September 7, 2016: Foot & Ankle Specialist
Mauro Dobran, Davide Nasi, Domenico Paolo Esposito, Maurizio Iacoangeli
OBJECTIVE: To evaluate the long term C1-C2 fusion rates, fracture healing and functional outcomes in geriatric patients with type II odontoid fracture treated with posterior fixation with polyaxial C1 lateral mass screws and C2 pars screws. METHODS: Twenty-one consecutive patients between 2005 and 2011 with Anderson and D'Alonzo type II odontoid fracture underwent a posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws. A long-term clinical and radiological follow-up was achieved in all patients with a mean follow-up period of 53...
September 1, 2016: World Neurosurgery
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