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Geriatric fracture

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https://www.readbyqxmd.com/read/28540117/orthogeriatric-combined-management-of-elderly-patients-with-proximal-femoral-fracture-results-of-a-1-year-follow-up
#1
Stefan Förch, Reiner Kretschmer, Thomas Haufe, Johannes Plath, Edgar Mayr
INTRODUCTION: According to the expected demographical changes, the number of elderly trauma patients will increase exponentially over the next decades. Different models of an interdisciplinary orthogeriatric care have been developed. But there is only limited evaluation of their benefit without clear and evidence-based results. In 2011, we monitored the results of our orthogeriatric combined management by conducting a 1-year follow-up. METHODS: We treated 231 patients presenting a proximal femoral fracture on our orthogeriatric ward...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#2
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28539681/risk-of-falls-in-the-rheumatic-patient-at-geriatric-age
#3
REVIEW
Agnieszka Prusinowska, Arkadiusz Komorowski, Teresa Sadura-Sieklucka, Krystyna Księżopolska-Orłowska
Evaluating the risk of falling of a geriatric rheumatic patient plays an essential role not only in planning and carrying out the physiotherapeutic process. The consequences of falls may be different and, although they do not always result in serious repercussions such as fractures or injuries, it is sufficient that they generate the fear of falling and cause a significant reduction in physical activity. Assessing functional capacity to define the risk of falling is of utmost importance in the case of patients after joint arthroplasty surgeries...
2017: Reumatologia
https://www.readbyqxmd.com/read/28538458/continuous-femoral-nerve-catheters-decrease-opioid-related-side-effects-and-increase-home-disposition-rates-among-geriatric-hip-fracture-patients
#4
Diren Arsoy, Michael J Gardner, Derek F Amanatullah, James I Huddleston, Stuart B Goodman, William J Maloney, Julius A Bishop
OBJECTIVE: To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment. INTERVENTION: One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28534471/management-of-acetabular-fractures-in-the-geriatric-patient
#5
Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler
INTRODUCTION: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20-25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR. METHODS: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient...
2017: SICOT-J
https://www.readbyqxmd.com/read/28513119/low-borderline-levels-of-serum-vitamin-b12-may-predict-cognitive-decline-in-elderly-hip-fracture-patients
#6
Eliyahu H Mizrahi, Emilia Lubart, Arthur Leibovitz
BACKGROUND: The progression from cognitive impairment to dementia is a multifactorial process that involves genetic and environmental factors. Vitamin B12 deficiency can be an important factor in the progress from cognitive decline to dementia. OBJECTIVES: To examine the relationship between borderline low level of vitamin B12 (≤ 350 pg/ml) and cognitive decline among a group of elderly hip fracture patients. METHODS: This retrospective chart review study was conducted in a geriatric rehabilitation ward of a university-affiliated referral hospital...
May 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28502379/external-validation-of-the-clinical-indications-of-computed-tomography-ct-of-the-head-in-patients-with-low-energy-geriatric-hip-fractures
#7
Amrut Borade, Harish Kempegowda, Hemil H Maniar, Anthony De Giacomo, Paul Tornetta, Kasey Bramlett, Andrew J Marcantonio, Lucas S Marchand, Erik N Kubiak, William H Ip, James F Kellam, Jay S Bender, Eric G Meinberg, James Kee, Regis Renard, Michael Suk, Daniel S Horwitz
INTRODUCTION: On evaluation of the clinical indications of computed tomography (CT) scan of head in the patients with low-energy geriatric hip fractures, Maniar et al. identified physical evidence of head injury, new onset confusion, and Glasgow Coma Scale (GCS)<15 as predictive risk factors for acute findings on CT scan. The goal of the present study was to validate these three criteria as predictive risk factors for a larger population in a wider geographical distribution. PATIENTS AND METHODS: Patients ≥65 years of age with low-energy hip fractures from 6 trauma centers in a wide geographical distribution in the United States were included in this study...
April 26, 2017: Injury
https://www.readbyqxmd.com/read/28497099/acetabular-fractures-in-the-senior-population-epidemiology-mortality-and-treatments
#8
Reza Firoozabadi, William W Cross, James C Krieg, Milton L Chip Routt
BACKGROUND: Management of acetabular fractures in the senior population can be one of the most challenging injuries to manage. Furthermore, treating surgeons have a paucity of information to guide the treatment in this patient population. THE PURPOSE OF THIS STUDY WAS TO DETERMINE: (1) demographic and epidemiologic data, (2) mortality rates for nonoperative compared to operative management at different time points, (3) common fracture configurations, and (4) fracture fixation strategies in senior patients treated with acetabular fractures...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488991/geriatric-hip-fracture-care-fixing-a-fragmented-system
#9
Mary E Anderson, Kelly Mcdevitt, Ethan Cumbler, Heather Bennett, Zachary Robison, Bryan Gomez, Jason W Stoneback
CONTEXT: Fragmentation in geriatric hip fracture care is a growing concern because of the aging population. Patients with hip fractures at our institution historically were admitted to multiple different services and units, leading to unnecessary variation in inpatient care. Such inconsistency contributed to delays in surgery, discharge, and functional recovery; hospital-acquired complications; failure to adhere to best practices in osteoporosis management; and poor coordination with outpatient practitioners...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28488559/-hip-fracture-in-elderly-patients-additional-value-of-a-multidisciplinary-approach-and-concentration-of-care
#10
P van der Vet, J Kussen, M van Dijk, R M Houwert, E J M M Verleisdonk, D van der Velde
Management of elderly patients with a proximal femoral fracture is an increasing challenge for the Dutch healthcare system. Proximal femoral fractures in the elderly have high morbidity and mortality rates. Furthermore, healthcare costs for this group of patients are rising. Referral, operation and postoperative care demand efficient collaboration between healthcare professionals. Every step in this chain of events is crucial for optimal treatment results. Multidisciplinary orthogeriatric trauma care shows promising results...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28480669/impact-of-the-holocaust-on-the-rehabilitation-outcome-of-older-patients-sustaining-a-hip-fracture
#11
Eliyahu H Mizrahi, Emilia Lubart, Anthony Heymann, Arthur Leibovitz
BACKGROUND: Holocaust survivors report a much higher prevalence of osteoporosis and fracture in the hip joint compared to those who were not Holocaust survivors. OBJECTIVES: To evaluate whether being a Holocaust survivor could affect the functional outcome of hip fracture in patients 64 years of age and older undergoing rehabilitation. METHODS: A retrospective cohort study compromising 140 consecutive hip fracture patients was conducted in a geriatric and rehabilitation department of a university-affiliated hospital...
April 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28465116/models-of-sarcopenia-short-review
#12
REVIEW
S Palus, J I Springer, W Doehner, S von Haehling, M Anker, S D Anker, J Springer
Approximately 40-50% of the population over 80years of age suffers from sarcopenia making this condition a major geriatric clinical disorder and a key challenge to healthy aging. The hallmark symptom of sarcopenia is the loss of muscle mass and strength without the loss of overall body weight. Sarcopenic patients are likely to have worse clinical outcomes and higher mortality compared to healthy individuals. This review will focus on animal models designed to study sarcopenia including hind-limb unloading, de-nervation, and immobilization by using casts or wire strategies, as well as using aged rodents...
April 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28465007/a-comparison-of-treatment-setting-for-elderly-patients-with-hip-fracture-is-the-geriatric-ward-superior-to-conventional-orthopedic-hospitalization
#13
Tal Frenkel Rutenberg, Efrat Daglan, Snir Heller, Steven Velkes
INTRODUCTION: Hip fractures in the elderly are a major cause of morbidity and mortality. The treatment settings of these patients may change their outcomes. The aim of this study is to compare the outcomes of patients with displaced femoral neck fractures who were admitted to the orthopedic vs. geriatric wards. PATIENTS AND METHODS: A retrospective study was conducted on 217 consecutive older patients with 219 displaced femoral neck fractures admitted either to the orthopedic or the geriatric ward between Jan...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28461962/anticoagulation-therapy-and-proximal-femoral-fracture-treatment-an-update
#14
Ioannis Ktistakis, Vasileios Giannoudis, Peter V Giannoudis
Hip fractures in the elderly population have become a 'disease' with increasing incidence.Most of the geriatric patients are affected by a number of comorbidities.Coagulopathies continue to be a special point of interest for the orthopaedic trauma surgeon, with the management of this high-risk group of patients a hot topic of debate among the orthopaedic community.While a universal consensus on how to manage thromboprophylaxis for this special cohort of patients has not been reached, multiple attempts to define a widely accepted protocol have been published...
August 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28459734/a-systematic-review-and-meta-analysis-examining-the-impact-of-incident-postoperative-delirium-on-mortality
#15
Gavin M Hamilton, Kathleen Wheeler, Joseph Di Michele, Manoj M Lalu, Daniel I McIsaac
BACKGROUND: Delirium is an acute and reversible geriatric syndrome that represents a decompensation of cerebral function. Delirium is associated with adverse postoperative outcomes, but controversy exists regarding whether delirium is an independent predictor of mortality. Thus, we assessed the association between incident postoperative delirium and mortality in adult noncardiac surgery patients. METHODS: A systematic search was conducted using Cochrane, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, and Embase...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28450739/comparing-mortality-risk-of-patients-with-acute-hip-fractures-admitted-to-a-major-trauma-centre-on-a-weekday-or-weekend
#16
Rajpal Nandra, Jack Pullan, Jonathan Bishop, Khalid Baloch, Liam Grover, Keith Porter
Proximal femoral fractures are a major public health concern with estimated annual direct and social costs amounting to £2 billion and average 30-day mortality risk of 7.5%. In response to the recent debate over out-of-hours hospital provision we investigated the 'weekend effect' at a major trauma centre, caring for acute injuries. A single centre, multi-surgeon review of 2060 patients performed. The distribution of patient and treatment variables compared in patients admitted on a weekday or the weekend. Fewer patients met performance indicators during weekend admission, time to surgery (63 vs...
April 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#17
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28419042/geriatric-fracture-care-future-trajectories-a-2015-aoa-critical-issues-symposium
#18
Julie A Switzer, Kevin J Bozic, Stephen L Kates
The population of the United States and the world is aging rapidly. Musculoskeletal care for older adults will be impacted by the manner in which health care is financed and the ability of the orthopaedic community to provide evidence-based integrated care for this population. We review the financial aspects of health-care reform and the implications for musculoskeletal care in the elderly. We discuss the establishment of quality measures for hip fracture care in the elderly, team building to accomplish this, and an innovative program designed to provide orthopaedic care to the frail elderly outside of the usual office setting...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28419035/clinical-practice-guidelines-decrease-unnecessary-echocardiograms-before-hip-fracture-surgery
#19
Chris Adair, Eric Swart, Rachel Seymour, Joshua Patt, Madhav A Karunakar
BACKGROUND: Preoperative assessment of geriatric patients with a hip fracture may include transthoracic echocardiography (TTE), which increases resource utilization and cost and may delay surgery. The purpose of this study was to evaluate preoperative TTE utilization at a single institution in order to determine (1) how often TTE is ordered in accordance with clinical practice guidelines (CPGs), (2) how frequently TTE reveals cardiac disease that may alter medical or anesthesia management, and (3) whether following CPGs reduces unnecessary TTE utilization without potentially missing important disease...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28415881/hip-and-pelvic-fracture-patients-with-fear-of-falling-development-and-description-of-the-step-by-step-treatment-protocol
#20
Karin Kampe, Michaela Kohler, Diana Albrecht, Clemens Becker, Martin Hautzinger, Ulrich Lindemann, Klaus Pfeiffer
OBJECTIVE: Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. RATIONALE: Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretical framework, from which the components of the intervention were derived. Description of the intervention: The intervention consists of 6 components: (1) relaxation, (2) meaningful activities and mobility-based goals, (3) falls related cognitions and emotions, coping with high risk tasks and situations, (4) individual exercise programme, (5) planning and implementing exercises and activities, and (6) fall risks and hazards...
May 2017: Clinical Rehabilitation
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