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Geriatric orthopaedics

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https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#1
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28919087/outcomes-of-restrictive-versus-liberal-transfusion-strategies-in-older-adults-from-nine-randomised-controlled-trials-a-systematic-review-and-meta-analysis
#2
Geoff I Simon, Alison Craswell, Ogilvie Thom, Yoke Lin Fung
BACKGROUND: Guidelines for patient blood management recommend restrictive transfusion practice for most adult patients. These guidelines are supported by evidence from randomised controlled trials (RCTs); however, one of the patient groups not explicitly examined in these studies is the geriatric population. We examined RCTs relevant to transfusion outcomes in older patients. Our aim was to determine whether special guidelines are warranted for geriatric patients, recognising the different pathophysiological characteristics of this group...
September 11, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#3
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/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#4
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28655169/hospital-at-home-integrated-care-programme-for-the-management-of-disabling-health-crises-in-older-patients-comparison-with-bed-based-intermediate-care
#5
Miquel À Mas, Marco Inzitari, Sergi Sabaté, Sebastià J Santaeugènia, Ramón Miralles
Objective: to analyse the clinical impact of a home-based Intermediate Care model in the Catalan health system, comparing it with usual bed-based care. Design: quasi-experimental longitudinal study. Setting: hospital Municipal de Badalona and El Carme Intermediate Care Hospital, Badalona, Catalonia, Spain. Participants: we included older patients with medical and orthopaedic disabling health crises in need of Comprehensive Geriatric Assessment (CGA) and rehabilitation...
June 24, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28631285/quality-assurance-of-falls-reduction-in-an-orthopaedic-ward-using-a-novel-bedside-trolley-table-set-up-strategy
#6
Shuang Quan Chan, Marianne Wadsley, Sue Ferriere
OBJECTIVE: To assess whether a novel bedside trolley table set-up decreased inpatient falls (IF) postintervention. METHODS: From December 2012 to December 2014, geriatric patients admitted to our orthopaedic ward with extreme falls risk had a bedside trolley placed between them and a floor sensor mat to give responders more time to prevent IF. Pre- and postintervention falls data was reviewed for falls reduction using falls per month as comparison standard. IF were classified as high or low/medium risk using St Thomas's Risk Assessment Tool In Falling Elderly inpatients (STRATIFY) scoring...
June 20, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28550459/patterns-of-drug-prescriptions-in-an-orthogeriatric-ward-as-compared-to-orthopaedic-ward-results-from-the-trondheim-hip-fracture-trial-a-randomised-clinical-trial
#7
Marianne Heltne, Ingvild Saltvedt, Stian Lydersen, Anders Prestmo, Olav Sletvold, Olav Spigset
PURPOSE: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. METHODS: Drugs prescribed at admission and discharge were registered from hospital records...
August 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28461962/anticoagulation-therapy-and-proximal-femoral-fracture-treatment-an-update
#8
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 reviews
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
#9
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
#10
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/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#11
REVIEW
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
July 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28360497/operative-repair-of-proximal-humerus-fractures-in-septuagenarians-and-octogenarians-does-chronologic-age-matter
#12
Abraham Michael Goch, Anthony Christiano, Sanjit Reddy Konda, Philipp Leucht, Kenneth Andrew Egol
BACKGROUND: With an expected doubling of the geriatric population within the next thirty years it is becoming increasingly important to determine who among the elderly population benefit from orthopaedic interventions. This study assesses post-operative outcomes in patients aged seventy or greater who sustained a proximal humerus fracture and were treated surgically as compared to a younger geriatric cohort to determine if there is a chronologic age after which post-operative outcomes significantly decline...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28303060/evaluation-of-the-association-between-locomotive-syndrome-and-depressive-states-a-cross-sectional-study
#13
Tomohiro Saito, Hideaki Watanabe, Ichiro Kikkawa, Katsushi Takeshita
The Japanese Orthopaedic Association has proposed the term "locomotive syndrome" to designate a condition that places a person at high risk for long-term care. However, in daily clinical practice, even when a diagnosis of locomotive syndrome is made, exercise therapy often cannot be successfully performed in some patients owing to their lack of motivation. We speculated that locomotive syndrome and depressive states co-exist in elderly people. The purpose of this study was to determine the presence or absence of depressive states in older patients aged ≥ 65 years who were diagnosed with locomotive syndrome...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28297828/-treatment-of-geriatric-ankle-osteoarthritis-by-arthrodesis-with-screw-fixation-through-lateral-malleolus-osteotomy
#14
W Q Qu, Z H Wang, J Y Zhang, S J Dong, D Wang
Objective: To evaluate the Treatment effect of geriatric ankle osteoarthritis by arthrodesis with screw fixation through lateral malleolus osteotomy. Methods: Thirty-three patients with severe osteoarthritis according to the classification of Takakura-Tanakawere treated by ankle arthrodesis through lateral malleolus osteotomy with screw fixation from January 2010 to June 2015. Twenty-five patients were combined with more than 1 internal diseases. Twenty-six patients owned ankle injury history. Clinical and radiologic evaluations were performed before surgery and at the most recent follow-up...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28255508/early-complications-following-osteosynthesis-of-distal-radius-fractures-a-comparison-of-geriatric-and-nongeriatric-cohorts
#15
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/28134674/clostridium-difficile-infection-an-orthopaedic-surgeon-s-guide-to-epidemiology-management-and-prevention
#16
REVIEW
Paul A Anderson, James Bernatz, Nasia Safdar
Clostridium difficile infection is a growing concern in health care and is a worrisome complication in orthopaedics. The incidence and severity of this infection are increasing, although the incidence following orthopaedic surgery is comparatively lower than that seen in patients in most other surgical specialties. The typical geriatric orthopaedic patient may have many risk factors that increase the likelihood of C difficile infection, including advanced age, residence in a long-term care facility, multiple comorbidities, the use of perioperative antibiotics, and a long length of stay...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28088377/intracapsular-hip-fractures-in-the-elderly-do-we-know-what-is-important
#17
Diana Crego-Vita, Coral Sanchez-Perez, Jose Adolfo Orellana Gomez-Rico, Celia Clemente de Arriba
BACKGROUND: Hip fractures in the elderly are a common reason for admission to the department of orthopaedic surgery, this condition asks an important part of health resources and is associated with high levels of co-morbidity and mortality. Many improvements have been introduced in the treatment of these patients, preoperative regional analgesia, intensive physical therapy, interdisciplinary care program; but still remain unresolved gaps. The aim of this study is to document the natural history of early versus delayed surgical intervention in elderly patients with hip fractures and to establish the prognostic factors of mortality and walking ability after discharge...
January 9, 2017: Injury
https://www.readbyqxmd.com/read/27990194/predictors-of-bone-status-by-quantitative-ultrasound-measurements-in-a-mountain-village-in-japan
#18
Tsuyoshi Tajika, Atsushi Yamamoto, Takashi Ohsawa, Noboru Oya, Haku Iizuka, Kenji Takagishi
BACKGROUND: It seems to be important to recognize predictors of bone health condition in Japanese super-aged society. The purpose of this study was to investigate predictors of the speed of sound (SOS) of calcaneus by quantitative ultrasound measurements of mountain village residents. MATERIALS AND METHODS: Medical examinations were conducted on 214 participants (69 men, 145 women; average age of 63.6 years). Each had completed a self-administered questionnaire including items such as gender, dominant hand, occupation, and history of smoking and drinking alcohol, experience of falls, and the EuroQol-5-dimensions-3-level Japanese version and a 25-question geriatric locomotive function scale proposed by the Japanese Orthopaedic Association...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27974304/improving-hip-fracture-outcomes-with-integrated-orthogeriatric-care-a-comparison-between-two-accepted-orthogeriatric-models
#19
Mark Middleton, Bettina Wan, Ruy da Assunçao
Background: our orthopaedic trauma unit serves a large elderly population, admitting 400-500 hip fractures annually. A higher than expected mortality was detected amongst these patients, prompting a change in the hip fracture pathway. The aim of this study was to assess the impact of a change in orthogeriatric provision on hip fracture outcomes and care quality indicators. Patients and Methods: the hip fracture pathway was changed from a geriatric consultation service to a completely integrated service on a dedicated orthogeriatric ward...
May 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#20
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
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