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Antibiotic use in femoral neck fracture

Vipin Sharma, Bhanu Awasthi, Krishna Kumar, Navneet Kohli, Punit Katoch
INTRODUCTION: Management of displaced fracture neck femur in the elderly population is frequently done by Hemiarthroplasty or Total Hip Replacement (THR). It avoids high rates of nonunion and avascular necrosis which usually occur after internal fixation of neck femur fractures in this age group. AIM: The present study aimed to evaluate patient function and complications following hemiarthroplasty and total hip replacement in elderly population with displaced femoral neck fractures...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Tomoki Nakamura, Akihiko Matsumine, Kunihiro Asanuma, Takao Matsubara, Akihiro Sudo
PURPOSE: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. METHODS: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentation was 35 years and the average follow-up time was 76 months...
2015: SICOT-J
E Tornero, L Morata, J C Martínez-Pastor, G Bori, C Climent, D M García-Velez, S García-Ramiro, J Bosch, J Mensa, A Soriano
Debridement, irrigation and antibiotic treatment form the current approach in early prosthetic joint infection (PJI). Our aim was to design a score to predict patients with a higher risk of failure. From 1999 to 2014 early PJIs were prospectively collected and retrospectively reviewed. The primary end-point was early failure defined as: 1) the need for unscheduled surgery, 2) death-related infection within the first 60 days after debridement or 3) the need for suppressive antibiotic treatment. A score was built-up according to the logistic regression coefficients of variables available before debridement...
August 2015: Clinical Microbiology and Infection
Marianne Westberg, Frede Frihagen, Ole-Christian Brun, Wender Figved, Bjarne Grøgaard, Haldor Valland, Helge Wangen, Finnur Snorrason
BACKGROUND: Surgical site infection (SSI) is a feared complication in hip arthroplasty, especially following femoral neck fracture in the elderly, associated with substantially increased morbidity, mortality, and costs. Gentamicin-containing collagen sponges are widely used for prevention of SSIs, but their effectiveness in joint replacement surgery remains unclear. METHODS: We performed a multicenter, randomized trial between February 2011 and July 2013. Eligible patients with femoral neck fracture undergoing hemiarthroplasty were randomly assigned to receive either intravenous antimicrobial prophylaxis alone or with the addition of 2 gentamicin-containing collagen sponges into the hip joint perioperatively...
June 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Yongsheng Chen, Amritpal Singh, Yiling Angeline Long, Yu Han Chee
This is the first clinical report of a psoas abscess encountered during a routine hemiarthroplasty surgery for a femoral neck fracture in a man with a recent urinary tract infection. There were no prior symptoms to suggest a psoas abscess, which was present on the same side as the hip fracture, apart from a history of recurrent urinary tract infection. The surgery had to be altered intraoperatively to that of an excision arthroplasty of the displaced non-viable femoral head along with insertion of an antibiotic-impregnated cement spacer into the hip joint...
2014: BMJ Case Reports
M Hrubina, M Skoták, J Běhounek St
PURPOSE OF THE STUDY: Evaluation of infectious complications in patients with proximal femoral fractures treated by osteosynthesis using dynamic hip screws (DHS). MATERIAL: The group included 501 patients with 532 DHS procedures performed in the years 1996-2010. In 31 patients osteosynthesis was carried out bilaterally. METHODS: Osteosynthesis was indicated for femoral neck fracture in 18 hips and for pertrochanteric fracture in 514 hips. Prophylactic antibiotic therapy was administered within 48 hours of surgery...
2013: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Shubhranshu S Mohanty, Mandar V Agashe, Binoti A Sheth, Kumar K Dash
BACKGROUND: Failed infected internal fixation produces significant pain and functional disability. In infected internal fixation of hip fractures with partial or complete head destruction, total hip arthroplasty (THA) can be technically challenging; however, it restores hip biomechanics. The present study is to evaluate the results and assess the complications of THA following failed infected internal fixation of these fractures. MATERIALS AND METHODS: A retrospective review of prospectively collected data in a tertiary healthcare center was performed of 20 consecutive patients of THA following failed infected internal fixation operated between September 2001 and November 2007...
January 2013: Indian Journal of Orthopaedics
Hasan Bombaci, Özgür Erdoğan, Fatih Çetinkaya, Mehmet Kuyumcu, Emre Kaya, Elif Bombaci
OBJECTIVE: In this study, we aimed to evaluate the factors which affect postoperative mortality in elderly patients with hip fractures and the reliability of the American Society of Anesthesiologists (ASA) classification. METHODS: The study included 107 patients (70 females, 37 males) of 65 years of age or older who were operated due to hip fracture. Preoperative laboratory and clinical data were collected from hospital files. Follow-up was conducted over the phone...
2012: Acta Orthopaedica et Traumatologica Turcica
Ke Liu, Jia Zheng, Yi Jin, Yong-Qiang Zhao
PURPOSE: To investigate the clinical outcome of two-stage revision total hip arthroplasty for infected hip arthroplasty using antibiotic-impregnated cement prosthesis. MATERIALS AND METHODS: Forty-one patients, who suffered from an infection after hip replacement or internal fixation of femoral neck and trochanteric fractures, were treated with a two-stage revision hip arthroplasty and followed up for an average of 37 months. All the patients were implanted with antibiotic-impregnated cement prosthesis as one-stage treatment and were then managed with two-stage revision hip arthroplasty after 12-24 weeks...
January 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Peter Craig, Ian Starks, Gordon Bancroft, Philip Roberts
BACKGROUND: Single dose Gentamicin (240 mg) has been shown to reduce postoperative wound infection in patients with fractured neck of femur when used in a combined antibiotic regimen. However, concerns have arisen about the risk of acute kidney injury (AKI) in these patients. OBJECTIVE: To determine if the use of prophylactic Gentamicin is associated with AKI in fractured neck of femur patients. METHODS: A historical cohort study. Pre- and post-operative creatinine mmol/l of 100 successive fractured neck of femur patients admitted from September 2010 were compared to a control of 100 age, sex and procedure matched individuals operated upon before the introduction of prophylactic Gentamicin (2005)...
December 2012: Injury
Jenneke J Deelstra, Danielle Neut, Paul C Jutte
We present a rare case of an immunocompetent host who developed a Candida albicans-infected total hip prosthesis. The infection could not be eradicated with debridement and extensive antifungal therapy. Our patient first underwent a resection of the proximal femur and local treatment with gentamicin-loaded cement beads. In a second procedure, a handmade cement spacer impregnated with voriconazole, amphotericin B, and vancomycin was placed. After 3 months of additional systemic antibiotic therapy, the patient remained afebrile, and a tumor prosthesis was placed...
February 2013: Journal of Arthroplasty
P Adam, R Philippe, M Ehlinger, O Roche, F Bonnomet, D Molé, M-H Fessy
INTRODUCTION: Displaced fractures of the femoral neck in the elderly are best treated with arthroplasty. The type of arthroplasty to be used, either hemi- or total hip arthroplasty, remains controversial as total hip replacements potentially have a higher rate of dislocation. HYPOTHESIS: Dual mobility cups have a low dislocation rate when used to manage acute fractures of the femoral neck. PATIENTS AND METHODS: In a multicenter prospective study conducted in France over an inclusion time of 3 months, all displaced fractures of the femoral neck treated with arthroplasty were operated on with insertion of a dual mobility cup...
May 2012: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ryszard Tomaszewski, Karol Pethe, Jacek Kler
INTRODUCTION: Disclosure of the tumor area intertrochanteric femur occurs mostly at the time of pathological fracture. Detection of changes can also be made in conjunction with x-ray of the hip joint such as the hip injury. The purpose of this study was to present the treatment of benign tumors of the intertrochanteric area in children and adolescents. MATERIALS AND METHODS: From 1. 01. 2002 to 31. 12. 2009 13 patients were treated with benign tumors of the femur intertrochanteric area, including 10 with pathological fractures in the background...
May 2011: Chirurgia Narzadów Ruchu i Ortopedia Polska
Jan Gessmann, Jessica Kammler, Thomas Armin Schildhauer, Andrzej Kaminski
PURPOSE: The aim of this study was to assess the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in patients admitted into a level 1 German trauma centre with proximal femur fractures, to correlate this incidence with defined risk factors for MRSA colonisation and to determine its influence on morbidity and mortality. METHODS: Between August and November 2006, 65 patients were included in the study. Cotton-tipped swab samples were taken from the nose, throat, groin and any skin defects in the emergency room...
January 2012: Langenbeck's Archives of Surgery
Y Chang, H-N Shih, D W Chen, M S Lee, S W Ueng, P-H Hsieh
We investigated the antibiotic concentration in fresh-frozen femoral head allografts harvested from two groups of living donors. Ten samples were collected from patients with osteoarthritis of the hip and ten from those with a fracture of the neck of the femur scheduled for primary arthroplasty. Cefazolin (1 g) was administered as a pre-operative prophylactic antibiotic. After storage at -80 degrees C for two weeks the pattern of release of cefazolin from morsellised femoral heads was evaluated by an in vitro broth elution assay using high-performance liquid chromatography...
October 2010: Journal of Bone and Joint Surgery. British Volume
J Bartonícek, P Dousa, M Krbec
UNLABELLED: Based on the analysis of their group of 75 patients treated for the fracture of proximal femur by means of the Gamma nail and on the analysis of data from the literature the authors present a comprehensive list of all complications resulting from this technique: inadequate reduction, -jamming of nail, fracture displacement by nail isertion, perforation of the head, incorrect length of the lag screw, problems with distal locking, fracture of the femoral shaft, rotation of head on the lag screw, rotation of diaphysis on the nail, failure of the healing of the wound and infection, breaking of the nail, non-union, healing in the varus position, aseptic necrosis of the head, incorrect rotational position of the limb, unequal length of lower limbs, problems with the set of instruments, migration of the set screw...
1998: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jarosław Deszczyński, Rafał Mikusek, Artur Pisarski, Artur Stolarczyk, Piotr Nowak
The aim of the study is clinical assessment of modular arthroplasty Fenix and early assessment of 77 patient with femoral neck fracture treated with Fenix hemiarthroplasty. The mean age of the group was 77 years. There were 51 woman and 16 men in the group. Size of the used steam and head, the way of steam implantation, time of the operation and early complication was assessed. Operated patients were evaluated with Harris Hip Score, Larson I and Larson II score. The most common used steams were number 3 and 4, and the most common used head was number 44 with -4 mm offset...
September 2009: Chirurgia Narzadów Ruchu i Ortopedia Polska
Jenson C S Mak, Ian D Cameron, Lyn M March
OBJECTIVE: To update evidence-based guidelines for the treatment of proximal femoral fractures published in the Journal in 2003. DATA SOURCES: Systematic search of MEDLINE, CINAHL and EMBASE for articles published from October 2001 to June 2008, and the Cochrane Database of Systematic Reviews (most recent issue searched - Issue 2, 2008). STUDY SELECTION: Randomised controlled trials and meta-analyses of all aspects of acute-care hospital treatment and rehabilitation for proximal femoral fractures among participants aged 50 years or older with proximal femoral fractures not associated with metastatic disease or multiple trauma...
January 4, 2010: Medical Journal of Australia
Mitsuaki Noda, Yasuhiro Saegusa, Yoshiyuki Takakura, Ryosuke Kuroda, Minoru Doita
Few articles describe the management of postoperative infection occurring after the use of an intramedullary nail in the treatment of femoral intertrochanteric fractures. Implant removal is frequently selected for postoperative infection control, especially in chronic cases. However, removal of the intramedullary nail causes a high rate of femoral neck fractures, challenging surgeons to prevent such fractures with few guidelines for how this can be done. This article presents 2 cases of postoperative infection following intramedullary nail implant in elderly women...
August 2009: Orthopedics
Jiong Jiong Guo, Huilin Yang, Haixin Qian, Lixin Huang, Zhongxing Guo, Tiansi Tang
BACKGROUND: It has been well recognized that malnutrition causes wounds to heal inadequately and incompletely. Malnutrition is often observed in the elderly, and it appears to be more severe in patients with hip fracture than in the general aging population. Few prospective studies give a detailed account of the identification and classification of nutritional status in the elderly. The objective of this study was to evaluate the effects of different nutritional measurements on wound healing status after hip fracture in the elderly...
March 2010: Journal of Surgical Research
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