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Geriatric fracture

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https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#1
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29325184/-distal-humerus-fracture-in-the-elderly
#2
Johannes E Plath, Stefan Förch, Thomas Haufe, Edgar Johann Mayr
Distal humerus fractures show increasing incidence with age. Due to preexisting osteoporosis, the surgeon is regularly confronted with complex comminuted intraarticular fractures. The maintenance of autonomy in daily life and avoidance of permanent care dependency is a dogma in the care of geriatric patients. Accordingly, a stable post-operative situation that allows early functional post-operative treatment is mandatory, especially in the elderly patient. Open reduction and stable internal fixation using double plate osteosynthesis are the current osteosynthetic standard of treatment...
January 11, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29318091/nerve-blocks-in-the-geriatric-patient-with-hip-fracture-a-review-of-the-current-literature-and-relevant-neuroanatomy
#3
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/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/29318079/the-effect-of-an-in-hospital-comprehensive-geriatric-assessment-on-short-term-mortality-during-orthogeriatric-hip-fracture-program-which-patients-benefit-the-most
#5
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/29314249/functional-performances-on-admission-predict-in-hospital-falls-injurious-falls-and-fractures-in-older-patients-a-prospective-study
#6
Mélany Hars, Marie-Claude Audet, François Herrmann, Jean De Chassey, René Rizzoli, Jean-Luc Reny, Gabriel Gold, Serge Ferrari, Andrea Trombetti
Falls are common among older inpatients, and remain a great challenge for hospitals. Despite the relevance of physical impairments to falls, the prognostic value of performance-based functional measures for in-hospital falls and injurious falls remains unknown. This study aimed to determine the predictive ability and accuracy of various functional tests administered at or close to admission in a geriatric hospital to identify in-hospital fallers and injurious fallers. In this prospective study, conducted in a geriatric hospital in Geneva (Switzerland), 807 inpatients (mean age, 85...
January 3, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29289543/comparison-of-3-frailty-instruments-in-a-geriatric-acute-care-setting-in-a-low-middle-income-country
#7
Sumika Mori Lin, Márlon Juliano Romero Aliberti, Sileno de Queiroz Fortes-Filho, Juliana de Araújo Melo, Ivan Aprahamian, Claudia Kimie Suemoto, Wilson Jacob Filho
OBJECTIVE: Comparison of frailty instruments in low-middle income countries, where the prevalence of frailty may be higher, is scarce. In addition, less complex diagnostic tools for frailty are important in these settings, especially in acutely ill patients, because of limited time and economic resources. We aimed to compare the performance of 3 frailty instruments for predicting adverse outcomes after 1 year of follow-up in older adults with an acute event or a chronic decompensated disease...
December 27, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29289445/incidence-risk-factors-and-clinical-implications-of-pneumonia-after-surgery-for-geriatric-hip-fracture
#8
Daniel D Bohl, Robert A Sershon, Bryan M Saltzman, Brian Darrith, Craig J Della Valle
BACKGROUND: Little is known regarding the occurrence of pneumonia after hip fracture surgery. The purpose of this study is to determine the incidence, risk factors, and clinical implications of pneumonia after surgery for geriatric hip fracture. METHODS: The American College of Surgeons National Surgical Quality Improvement Program was used to retrospectively study geriatric patients undergoing surgery for hip fracture during 2006-2014. Independent risk factors for developing pneumonia within 30 days of surgery were identified using multivariate regression...
December 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29258687/analysis-of-mortality-and-fixation-failure-in-geriatric-fractures-using-quantitative-computed-tomography
#9
Tyler S Pidgeon, Joey P Johnson, Matthew E Deren, Andrew R Evans, Roman A Hayda
OBJECTIVES: While osteoporosis has been shown to be a contributing factor in low energy fractures in the elderly, limited data exists regarding the correlation of bone mineral density (BMD) and T-Scores to mortality and failure of fracture fixation. This study seeks to determine the relationship between femoral neck BMD in elderly patients with typical geriatric fractures and mortality and fracture fixation failure using Quantitative Computed Tomography (QCT). MATERIALS AND METHODS: Patients over the age of 65 who sustained fractures of the proximal humerus, distal radius, pelvic ring, acetabulum, hip, proximal tibia, and ankle who also underwent a CT scan that included an uninjured femoral neck were retrospectively reviewed...
December 15, 2017: Injury
https://www.readbyqxmd.com/read/29251181/assessment-of-geriatric-predictors-of-adherence-to-zoledronic-acid-treatment-for-osteoporosis-a-prospective-follow-up-study
#10
Ilker Tasci, Umit Cintosun, Umut Safer, M Ilkin Naharci, Ergun Bozoglu, Aydogan Aydogdu, Huseyin Doruk
Objectives Discontinuation of bisphosphonate treatment remains high even with the long acting parenteral options. Whether there are some unidentified causes of noncompliance more specific to aged individuals is unknown. The aim of this study was to investigate baseline predictors of adherence to Zoledronic acid (ZOL) infusions among non-demented older adults with osteoporosis. Methods Patients aged ≥ 65 years who received a first ever ZOL infusion for osteoporosis were prospectively enrolled. Risk factors for osteoporosis and fractures, comorbidities, geriatric assessment measures, including depression, and anticholinergic burden were determined at baseline...
December 18, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29249533/is-prescribed-lower-extremity-weight-bearing-status-after-geriatric-lower-extremity-trauma-associated-with-increased-mortality
#11
Ida Leah Gitajn, Daniel Connelly, Daniel Mascarenhas, Stephen Breazeale, Peter Berger, Carrie Schoonover, Brook Martin, Robert V O'Toole, Raymond Pensy, Marcus Sciadini
OBJECTIVES: Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. DESIGN: Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p < 0...
December 14, 2017: Injury
https://www.readbyqxmd.com/read/29243059/standardised-pre-operative-diagnostics-and-treatment-of-peripheral-arterial-disease-reduce-wound-complications-in-geriatric-ankle-fractures
#12
René Aigner, Philipp Lechler, Christoph Kolja Boese, Benjamin Bockmann, Steffen Ruchholtz, Michael Frink
PURPOSE: The aim of this study was to evaluate a standardised algorithm to assess and treat impaired limb perfusion prior to surgical fixation of geriatric ankle fractures and determine the prevalence of peripheral arterial disease (PAD) in geriatric patients presenting with ankle fractures. METHODS: Eighty-four patients >65 years pre-operatively diagnosed and treated according to an algorithm (study group) were compared with 84 patients diagnosed and treated before the algorithm was introduced (control group)...
December 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29226660/bone-and-joint-diseases-in-present-and-future
#13
Yasuharu Nakashima, Ken Okazak, Koichiet Nakayama, Seiji Okada, Hideki Mizu-uchi
With the increase of elderly population, orthopaedic surgeons need to deal with the diseases related to aging, such as joint disorders and fragility fractures. The number of total joint replacements, for example, is two times more than it was 10 years ago. With these backgrounds, the Japanese Orthopaedic Association (JOA) has proposed the concept of locomotive syndrome; conditions under which the elderly have been receiving care services due to problems of the locomotive organs. To prevent geriatric or disuse syndrome, JOA is currently providing the care‒prevention programs such as the loco-check and loco-training...
January 2017: Fukuoka Igaku Zasshi, Hukuoka Acta Medica
https://www.readbyqxmd.com/read/29224055/peri-operative-antibiotic-treatment-of-bacteriuria-reduces-early-deep-surgical-site-infections-in-geriatric-patients-with-proximal-femur-fracture
#14
Ronny Langenhan, Stefanie Bushuven, Niklas Reimers, Axel Probst
PURPOSE: The aim of this study was to conduct a re-evaluation of current strategies for peri-operative prophylaxis of infections in orthopaedic surgery of geriatric patients (≥65 years) with proximal femoral fractures (PFF). METHODS: Between 01/2010 and 08/2014 all post-operative infections after stabilization of PFF of 1,089 geriatric patients were recorded retrospectively. All patients pre-operatively received a single dose of 1.5 g cefuroxime (group 1). These were compared to prospectively determined post-operative rates of surgical site infection (SSI) of 441 geriatric patients, which were operated on between 09/2014 and 03/2017 due to PFF...
December 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#15
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29202811/high-prevalence-of-prescription-of-psychotropic-drugs-for-older-patients-in-a-general-hospital
#16
Inken Arnold, Kati Straube, Wolfgang Himmel, Stephanie Heinemann, Vivien Weiss, Laura Heyden, Eva Hummers-Pradier, Roland Nau
BACKGROUND: Many elderly patients receive psychotropic drugs. Treatment with psychotropic agents is associated with serious side effects including an increased risk of falls and fractures. Several psychotropic drugs are considered potentially inappropriate for treatment of the elderly. METHODS: A retrospective chart review was conducted covering all patients aged ≥ 65 years who were admitted to Evangelisches Krankenhaus Göttingen-Weende between 01/01/2013 and 03/31/2013...
December 4, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29198046/is-treatment-of-geriatric-hip-fracture-patients-cost-covering-results-of-a-prospective-study-conducted-at-a-german-university-hospital
#17
Rene Aigner, Juliana Hack, Daphne Eschbach, Steffen Ruchholtz, Matthias Knobe, Richard Dodel, Benjamin Buecking
INTRODUCTION: Hip fractures have increased medical and socio-economic importance due to demographic transition. Information concerning direct treatment costs and their reimbursement in Germany is lacking. MATERIALS AND METHODS: Four hundred two hip fracture patients older than 60 years of age were observed prospectively at a German University Hospital. Treatment costs were determined with up to 196 cost factors and compared to the reimbursement. Finally, statistical analysis was performed to identify clinical parameters influencing the cost-reimbursement relation...
December 2, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29197959/fractures-frequently-occur-in-older-cancer-patients-the-md-anderson-cancer-center-experience
#18
Beatrice J Edwards, Ming Sun, Xiaotao Zhang, Holly M Holmes, Juhee Song, Peter Khalil, Meghan Karuturi, Jay B Shah, Colin P Dinney, Robert F Gagel, Vicente Valero, Richard E Champlin, Debasish Tripathy, William A Murphy
PURPOSE AND INTRODUCTION: A growing number of cancer patients are older adults aged 65 years and older. Patients with cancer are at increased risk for developing osteoporosis, falls, and fractures. We sought to identify the incidence of fractures in older adults who underwent cancer care between January 2013 and December 2015. METHODS: A comprehensive geriatric assessment was performed, and bone densitometry was measured at baseline, with a 2-year follow-up. RESULTS: In this study, among 304 patients with gastrointestinal, urologic, breast, lung, and gynecologic cancers we evaluated, and who completed the bone density testing (n = 199), 80% had osteoporosis or low bone mass (osteopenia)...
December 2, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29181200/epidemiology-of-c2-fractures-in-the-21st-century-a-national-registry-cohort-study-of-6-370-patients-from-1997-to-2014
#19
Anna-Lena Robinson, Claes Olerud, Yohan Robinson
Objective: C2 fractures are a common injury in the elderly population. Treatment is often complicated due to osteoporosis and patient comorbidity. This study aims to investigate the incidence and treatment trend of C2 fractures in Sweden. Methods: Patients with the principal and secondary diagnosis of fracture of the second vertebrae (ICD-10: S12.1) between 1997 and 2014 were identified in the Swedish National Patient Registry (NPR). Results: Between 1997 and 2014, 6,370 patients with a C2 fracture (51% male; age: 72 ± 18) were identified in the NPR...
2017: Advances in Orthopedics
https://www.readbyqxmd.com/read/29175643/sustained-release-multiparticulates-for-oral-delivery-of-a-novel-peptidic-ghrelin-agonist-formulation-design-and-in-vitro-characterization
#20
Ken Howick, Ryan Alam, Barbara Chruscicka, Dalia Kandil, Dara Fitzpatrick, Aoife M Ryan, John F Cryan, Harriët Schellekens, Brendan T Griffin
There is an impetus to provide appropriate sustained release oral delivery vehicles to protect biofunctional peptide loads from gastric degradation in vivo. This study describes the generation of a high load capacity pellet formulation for sustained release of a freely water-soluble dairy-derived hydrolysate, FHI-2571. The activity of this novel peptidic ghrelin receptor agonist is reported using in vitro calcium mobilization assays. Conventional extrusion spheronization was then used to prepare peptide-loaded pellets which were subsequently coated with ethylcellulose (EC) film coats using a fluid bed coating system in bottom spray (Wurster) mode...
November 23, 2017: International Journal of Pharmaceutics
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