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https://www.readbyqxmd.com/read/30341135/improve-hip-fracture-outcome-in-the-elderly-patient-ihope-a-study-protocol-for-a-pragmatic-multicentre-randomised-controlled-trial-to-test-the-efficacy-of-spinal-versus-general-anaesthesia
#1
Ana Kowark, Christian Adam, Jörg Ahrens, Malek Bajbouj, Cornelius Bollheimer, Matthias Borowski, Richard Dodel, Michael Dolch, Thomas Hachenberg, Dietrich Henzler, Frank Hildebrand, Ralf-Dieter Hilgers, Andreas Hoeft, Susanne Isfort, Peter Kienbaum, Mathias Knobe, Pascal Knuefermann, Peter Kranke, Rita Laufenberg-Feldmann, Carla Nau, Mark D Neuman, Cynthia Olotu, Christopher Rex, Rolf Rossaint, Robert D Sanders, Rene Schmidt, Frank Schneider, Hartmut Siebert, Max Skorning, Claudia Spies, Oliver Vicent, Frank Wappler, Dieter Christian Wirtz, Maria Wittmann, Kai Zacharowski, Alexander Zarbock, Mark Coburn
INTRODUCTION: Hip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse. METHODS AND ANALYSIS: The iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design...
October 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/30340916/impact-of-frailty-on-outcomes-after-primary-and-revision-total-hip-arthroplasty
#2
Rebecca L Johnson, Matthew P Abdel, Ryan D Frank, Alanna M Chamberlain, Elizabeth B Habermann, Carlos B Mantilla
BACKGROUND: Frailty and disability from arthritis are closely intertwined and little is known about the impact of frailty on total hip arthroplasty (THA) outcomes. We hypothesized that higher preoperative frailty is associated with more adverse events following THA. METHODS: All patients (≥50 years) undergoing unilateral primary or revision THA at a single institution from 2005 through 2016 were included. We analyzed the association of frailty (measured by a frailty deficit index) with postoperative outcomes in hospital, within 90 days, and within 1 year using multivariable logistic and Cox regression, adjusting for age...
September 25, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30339646/hepatitis-c-is-an-independent-risk-factor-for-perioperative-complications-and-nonroutine-discharge-in-patients-treated-surgically-for-hip-fractures
#3
Luis Grau, Erik Zachwieja, Spencer H Summers, Dustin H Massel, Alvin Ong, Victor H Hernandez, Omri Merose
OBJECTIVE: To evaluate the relationship between noncirrhotic hepatitis C virus (HCV) infection, perioperative complications, and discharge status in patients undergoing surgical procedures for hip fractures. METHODS: A retrospective epidemiological study was performed, querying the National Hospital Discharge Survey. Patients were selected using the International Classification of Diseases-9 diagnostic codes for hip fracture and primary procedural codes for open reduction internal fixation, hemiarthroplasty, total hip arthroplasty, or internal fixation...
November 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/30338339/outcomes-of-acetabular-fractures-in-the-elderly-a-five-year-retrospective-study-of-twenty-seven-patients-with-primary-total-hip-replacement
#4
Jean-Charles Giunta, Camille Tronc, Gael Kerschbaumer, Michel Milaire, Sébastien Ruatti, Jerôme Tonetti, Mehdi Boudissa
PURPOSES: Open reduction and internal fixation (ORIF) in osteoporotic acetabular fractures is quite difficult with high risk of implant failure. Total hip arthroplasty (THA) may be an effective option for treating acetabular fractures in appropriately selected patients, with immediate full weightbearing. The aim of the study was to evaluate the functional outcomes of primary THA for acetabular fractures in elderly patients. METHODS: Between 2010 and 2015, 27 elderly patients operated for acetabular fractures by primary THA were included...
October 18, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/30334845/assessing-the-value-of-routine-pathologic-examination-of-resected-femoral-head-specimens-after-femoral-neck-fracture
#5
Jason A Davis, Geoffrey Rohlfing, Kenan Sagouspe, Maximino Brambila
INTRODUCTION: The purpose of this study was to evaluate the efficacy of routine pathologic examination (PE) of femoral head (FH) specimens after arthroplasty for acute femoral neck fractures and to determine the cost. METHODS: This was a retrospective chart review of 850 acute femoral neck fractures treated with hemiarthroplasty or total hip arthroplasty These were evaluated to determine whether the FH was sent for PE, the resultant findings, alterations in medical treatment, and cost...
October 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/30334549/ex-vivo-evaluation-of-hip-fracture-risk-by-proximal-femur-geometry-and-bone-mineral-density-in-elderly-chinese-women
#6
Xiao-Jiang Yang, Hong-Xun Sang, Bo Bai, Xiang-Yu Ma, Chao Xu, Wei Lei, Yang Zhang
BACKGROUND The incidence of hip fracture is steadily increasing. We aimed to establish a creative approach to precisely estimate the risk of hip fracture by exploring the relationship between hip fracture and bone mineral density (BMD)/femur geometry. MATERIAL AND METHODS Sixteen samples of cadaveric female proximal femora were randomly selected. Experiments were performed experimental measurement of the femoral neck BMD and geometric parameters (including neck length, neck diameter, head diameter, and neck-shaft angle)...
October 18, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/30334182/predicting-fracture-risk-in-younger-postmenopausal-women-comparison-of-the-garvan-and-frax-risk-calculators-in-the-women-s-health-initiative-study
#7
Carolyn J Crandall, Joseph Larson, Andrea LaCroix, Jane A Cauley, Meryl S LeBoff, Wenjun Li, Erin S LeBlanc, Beatrice J Edwards, JoAnn E Manson, Kristine Ensrud
BACKGROUND: Guidelines recommend fracture risk assessment in postmenopausal women aged 50-64, but the optimal method is unknown. OBJECTIVES: To compare discrimination and calibration of the Fracture Risk Assessment Tool (FRAX) and Garvan fracture risk calculator for predicting fractures in postmenopausal women aged 50-64 at baseline. DESIGN: Prospective observational study. PARTICIPANTS: Sixty-three thousand seven hundred twenty-three postmenopausal women aged 50-64 years participating in the Women's Health Initiative Observational Study and Clinical Trials...
October 17, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/30332885/-classification-and-reconstruction-of-acetabular-defects-in-revision-total-hip-arthroplasty
#8
REVIEW
Zhi-Wei Kang, Yao-Hui Zhang, Zi-Quan Yang
As a mature technology gradually, the total hip arthroplasty has been known and conducted by more and more orthopedic surgeons. However, it also increased the number of hip revisions. The reasons for revision of hip mainly include: unstable, infection, aseptic loosening prosthesis, prosthesis peripheral fracture, liner wear and so on, and the acetabulum bone defect and the choice of acetabular prosthesis have been perplexing surgeons. In this paper, we summarise classification and reconstruction of acetabulum bone defect in hip revision oprations, compare the advantages and disadvantages of all kinds of classification, on this basis can have more than one bone grafting mode and the choice of the acetabulum prosthesis for reconstruction of acetabulum, then expound the ways of material sources, bone grafting modes and complex acetabulum bone defect reconstruction as well as the choice of the ways of fixed prosthesis, providing the basis for clinical doctors to deal with all kinds of acetabulum bone defect and the choice of the acetabulum prosthesis, guiding patient specific therapy more precisely...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30332883/-a-reduction-technique-for-the-treatment-of-refractory-femoral-trochanteric-fracture
#9
Wei-Wei Wu, Min-Chao Hu, Yan-Li Yu, Bin Guo
OBJECTIVE: To explore the effect of periosteal stripper through spiral blade incision combined with lateral sight bracket prying method in the treatment of irreducible femoral trochanteric fractures with proximal upwarping of fracture. METHODS: From March 2015 to October 2017, 26 patients with refractory femoral trochanteric fractures with proximal upwarp of fracture were treated by periosteal dissection through a spiral blade incision and lateral sight bracket prying, included 9 males and 17 females with an average age of (76...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30332881/-treatment-of-pipkin-i-and-ii-hip-fractures-by-anterolateral-hip-approach
#10
Jian-Hua Han, Hai-Feng Wang, Fang-Hu Chen, Gang Chen
OBJECTIVE: To investigate the clinical effect of absorbable screw fixation by anterolateral approach (McFarland and Osborne approach) for the treatment of Pipkin type I and type II fractures. METHODS: From March 2008 to February 2016, 8 cases of femoral head fractures were treated by absorbable screw fixation through anterolateral approach (McFarland and Osborne approach) including 5 males and 3 females with an average age of 36 years old ranging 23 to 58 years old...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30332878/-pfna-combined-reconstruction-and-locking-titanium-plate-for-the-treatment-of-comminuted-femoral-intertrochanteric-fractures-involving-lateral-wall
#11
Zhi-Xiang Chen, Zhen-Yu Zhou, Fan Liu, Feng Yang, Chuan-Gong Wang
OBJECTIVE: To investigate the operative effect of PFNA combined with reconstructive locking plate on the treatment of comminuted femoral intertrochanteric fracture which involving the lateral wall. METHODS: A total of 35 patients with comminuted femoral intertrochanteric fractures involving the lateral wall were surgically treated from November 2014 to January 2016. According to whether there was reconstruction of the lateral wall or not and the internal fixation method, the patients were divided into PFNA group (no reconstruction of the lateral wall), PFNA recontruction group (reconstructive locking plate was used to reconstruct the lateral wall, PFNA internal fixation)...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30332877/-analysis-of-influence-of-sarcopenia-on-early-postoperative-function-of-femoral-neck-fracture-by-hip-arthroplasty
#12
Jun-Zhe Lang, Cong-Cong Wu, Jian-Feng Jin, Peng Wu, Lei Hen
OBJECTIVE: To determine the association of sarcopenia with short-term postoperative function after hip replacement for femoral neck fractures. METHODS: A prospective study of 181 consecutive patients with femoral neck fractures who underwent hip replacement from May 2014 to January 2017 were performed, including 58 males and 123 females aging from 53 to 92 years old. The general conditions were collected before surgery, skeletal muscle index(ASMI), handgrip strength were measured...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30332874/-hemiarthroplasty-for-the-treatment-of-complicated-femoral-intertrochanteric-fracture-in-elderly-patients
#13
Feng Wang, Chen Meng, Xing-Bing Cao, Qi Chen, Xiao-Feng Xu, Qian Chen
OBJECTIVE: To discuss the hemiarthroplasty for the threatment of femoral intertrochanteric fracture in elderly patients. METHODS: From August 2013 to January 2017, 66 elderly patients with complicated femoral intertrochanteric fracture were treated including 20 males and 46 females with an average age of 85 years old ranging from 80 to 95. According to improve Evans classification, 33 cases were type III, 24 cases were type IV, 9 cases were type V. History included 31 cases of hypertension, 10 cases of diabetes, 12 cases of severe osteoporosis, 5 cases of atrial fibrillation, 3 cases of pulmonary heart disease, and 1 case of multiple myeloma...
September 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30328746/low-molecular-weight-heparin-for-hip-fracture-patients-treated-with-osteosynthesis-should-thromboprophylaxis-start-before-or-after-surgery-an-observational-study-of-45-913-hip-fractures-reported-to-the-norwegian-hip-fracture-register
#14
Sunniva Leer-Salvesen, Eva Dybvik, Lars B Engesaeter, Ola E Dahl, Jan-Erik Gjertsen
Background and purpose - Controversies exist regarding thromboprophylaxis in orthopedic surgery. We studied whether the thromboprophylaxis in hip fracture patients treated with osteosynthesis should start preoperatively or postoperatively. Data were extracted from the nationwide Norwegian Hip Fracture Register (NHFR). The risks of postoperative deaths, reoperations, and intraoperative bleeding were studied within 6 months after surgery. Patients and methods - After each operation for hip fracture in Norway the surgeon reports information on the patient, the fracture, and the operation to the NHFR...
October 17, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/30328742/impact-of-hospitalist-vs-non-hospitalist-services-on-length-of-stay-and-30-day-readmission-rate-in-hip-fracture-patients
#15
John R Stephens, Jamison W Chang, Allen Liles, Mukhtar Adem, Carlton Moore
OBJECTIVES: Hip fracture is a common and morbid condition, affecting a patient population with significant medical co-morbidities. A number of medical co-management models have been studied, with conflicting reports of effect on patient outcomes. Our objective was to compare outcomes for patients with hip fracture managed by hospitalist vs. non-hospitalist services at an academic medical center. METHODS: We conducted a retrospective cohort study of patients with hip fracture over one year, comparing those on hospitalist vs...
October 17, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/30327836/the-implementation-of-a-clinical-pathway-enhancing-early-surgery-for-geriatric-hip-fractures-how-to-maintain-a-success-story
#16
An Sermon, Ine Rochus, Bart Smeets, Willem-Jan Metsemakers, Dominique Misselyn, Stefaan Nijs, Harm Hoekstra
BACKGROUND: Timing of surgery in geriatric hip fracture treatment remains controversial. Early surgery is acknowledged as a quality indicator and NICE guidelines recommend surgery within 0-48 h from admission. In 2014 we implemented the indicator of early surgery in our institution, enhancing operative treatment within the next calendar day. We aimed to evaluate the implementation, define the room for improvement and provide strategies to maintain the quality indicator. METHODS: Clinical outcome of 744 patients (January 2011-December 2013) before early surgery was implemented, compared to 817 patients (June 2014-May 2017) after implementation of early surgery with a follow-up of 6 months...
October 16, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/30327739/diagnostic-quandary-salmonella-agbeni-vertebral-osteomyelitis-and-epidural-abscess
#17
Ryan K Dahlberg, Mary Elizabeth Lyvers, Thomas K Dahlberg
Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/30326950/preoperative-dual-energy-x-ray-absorptiometry-and-frax-in-patients-with-lumbar-spinal-stenosis
#18
Camilla Bergh, Ann-Charlott Söderpalm, Helena Brisby
BACKGROUND: Osteoporosis implies an increased risk of complications after orthopedic surgery. For the mostly elderly group of patients undergoing lumbar spinal stenosis surgery (LSS), it is important to include skeletal health evaluation in the preoperative planning. The aim of this study was to assess spine and femoral neck (FN) bone mineral density (BMD) in LSS patients and to evaluate whether the World Health Organization (WHO) fracture risk assessment tool (FRAX) can identify patients with reduced BMD levels in the spine...
October 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/30326729/diagnostic-accuracy-of-digital-radiography-for-the-diagnosis-of-osteonecrosis-of-the-femoral-head-revisited
#19
Choong Guen Chee, Jungheum Cho, Yusuhn Kang, Youngjune Kim, Eugene Lee, Joon Woo Lee, Joong Mo Ahn, Heung Sik Kang
Background The radiographic diagnosis of osteonecrosis of the femoral head (ONFH) is challenging for radiologists. Purpose To measure the sensitivity and specificity of digital radiography for diagnosing ONFH and to evaluate the diagnostic value of the frog-leg view. Material and Methods Patients diagnosed with ONFH by magnetic resonance imaging (MRI) (n = 132) and normal controls (n = 69) were included. Two radiologists independently graded the likelihood of ONFH and subchondral fracture on radiographs...
October 16, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/30326415/staple-versus-suture-closure-for-ankle-fracture-fixation-retrospective-chart-review-for-safety-and-outcomes
#20
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
August 22, 2018: Foot
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