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Hip AND Fracture

Ruth M Tappen, David Newman, Peter Huckfeldt, Zhiyou Yang, Gabriella Engstrom, David G Wolf, Jill Shutes, Carolina Rojido, Joseph G Ouslander
BACKGROUND: Medicare incentivizes the reduction of hospitalizations of nursing facility (NF) residents. The effects of these incentives on resident safety have not been examined. OBJECTIVE: Examine safety indicators in NFs participating in a randomized, controlled trial of the INTERACT Quality Improvement Program. DESIGN: Secondary analysis of a randomized trial in which intervention NFs exhibited a statistically nonsignificant reduction in hospitalizations...
August 11, 2018: Journal of the American Medical Directors Association
Daniel Pincus, David Wasserstein, Bheeshma Ravi, Anjie Huang, J Michael Paterson, Richard J Jenkinson, Hans J Kreder, Avery B Nathens, Walter P Wodchis
BACKGROUND: Waiting for hip fracture surgery is associated with complications. The objective of this study was to determine whether waiting for hip fracture surgery is associated with health-care costs. METHODS: We conducted a population-based, propensity-matched cohort study of patients treated between 2009 and 2014 in Ontario, Canada. The primary exposure was early hip fracture surgery, performed within 24 hours after arrival at the emergency department. The primary outcome was direct medical costs, estimated for each patient in 2013 Canadian dollars, from the payer perspective...
August 15, 2018: Journal of Bone and Joint Surgery. American Volume
Michael Willey, Matthew L Welsh, Travis S Roth, Kenneth J Koval, James V Nepola
Recent estimates suggest an annual incidence of greater than 125,000 femoral neck fractures. Surgical treatment is indicated for the majority of these fractures, which are estimated to double by the year 2050. Most displaced femoral neck fractures in elderly patients are treated with arthroplasty secondary to high complication rates associated with internal fixation. Traditional implants used for internal fixation, typically in elderly patients with stable fracture morphology and younger patients regardless of morphology, include the sliding hip screw (SHS), with or without a supplemental anti-rotation screw, and multiple cancellous lag screws...
2018: Iowa Orthopaedic Journal
Jie-Feng Huang, Xian-Jun Jiang, Jian-Jian Shen, Ying Zhong, Pei-Jian Tong, Xiao-Hong Fan
BACKGROUND: The Unified Classification System (UCS) for Periprosthetic femoral fractures (PPFF) still has some limitations. METHODS: We retrieved 18 previous classifications for PPFF based on systematic review of the literature, and also retrospectively analyzed 402 cases with PPFF. 46 cases (11.4%) were identified as beyond the classification scope of the original UCS. RESULTS: We modified the UCS as follows: (1) add two new B2 subtypes: B2PALT/B2PAGT (i...
August 10, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Zhiqiang Wang, Yi Yin, Qingshan Li, Guanjun Sun, Xu Peng, Hua Yin, Yongjie Ye
BACKGROUND: The incidence of early postoperative complications of displaced intracapsular hip fractures is high. The purpose of this study was to compare the early postoperative complications and assess the incidence of femoral neck shortening on using a newly designed proximal femoral cannulated screw locking plate (CSLP) versus multiple cancellous screws (MCS) in the treatment of displaced intracapsular hip fractures in young adults. METHODS: Sixty-eight young adult patients with displaced intracapsular hip fractures were randomly assigned to either the CSLP group or the MCS group and treated routinely by internal fixation with either the CSLP or the MCS...
August 13, 2018: Journal of Orthopaedic Surgery and Research
J A Nicholson, C E H Scott, J Annan, I Ahmed, J F Keating
AIM: The aim of this study was to evaluate the long-term clinical outcomes and complications following an acetabular fracture associated with a posterior hip dislocation compared to those without dislocation. PATIENTS & METHODS: A retrospective cohort study of 113 patients (mean age 42 (14-95), 77% male) with acetabular fracture dislocations compared to 367 patients with acetabular fractures without dislocation (mean age 54 (16-100), 66% male) treated from 1988 to 2010...
July 29, 2018: Injury
Muhammad Haroon, Kamil Khan, Lorraine Thong, Kabir Ali, Fayyaz Janjua
AIMS: (1) To calculate the absolute fracture risk by using the fracture risk assessment (FRAX) model among elderly medical inpatients; (2) to assess the risk of falls, especially among patients with increased risk of fractures; and (3) to design and implement a bone health protocol to improve the assessment of fracture risk. METHODS: The study participants were all inpatients admitted to the medical wards at University Hospital Kerry, Ireland. All consecutive eligible patients aged ≥ 65 years were prospectively evaluated to populate clinical risk factor variables used in the FRAX model and the fall assessment was made by using Fracture Risk Questionnaire...
August 11, 2018: Irish Journal of Medical Science
Bernard Cortet, Stéphanie Lucas, Isabelle Legroux-Gerot, Guillaume Penel, Christophe Chauveau, Julien Paccou
Both type 1 and type 2 diabetes mellitus are associated with bone disorders, albeit via different mechanisms. Early studies in patients with type 1 diabetes suggested a 10-fold increase in the hip fracture risk compared to nondiabetic controls. Metaanalyses published more recently indicate a somewhat smaller risk increase, with odds ratios of 6 to 7. Diminished bone mineral density is among the contributors to the increased fracture risk. Both types of diabetes are associated with decreased bone strength related to low bone turnover...
August 8, 2018: Joint, Bone, Spine: Revue du Rhumatisme
J Ramalho, I D B Marques, Didier Hans, David Dempster, Hua Zhou, Parth Patel, R M R Pereira, V Jorgetti, R M A Moyses, Thomas L Nickolas
The trabecular bone score (TBS) is a novel tool using grayscale variograms of the lumbar spine bone mineral density (BMD) to assess trabecular bone microarchitecture. Studies in patients with chronic kidney disease (CKD) suggest it may be helpful in assessing fracture risk. However, TBS has not been validated as a measure of trabecular architecture against transiliac bone biopsy with histomorphometry in CKD patients. We hypothesized that TBS would reflect trabecular architecture at the iliac crest in CKD patients...
August 8, 2018: Bone
Takeshi Utsunomiya, Goro Motomura, Satoshi Ikemura, Yusuke Kubo, Kazuhiko Sonoda, Hiroyuki Hatanaka, Shoji Baba, Koichiro Kawano, Takuaki Yamamoto, Yasuharu Nakashima
Stress distribution remains unclear in early-stage osteonecrosis of the femoral head (ONFH). To clarify this issue, we generated patient-specific finite element models (FEMs) from 51 patients with ONFH. Patients' hips were classified into three groups: ONFH without a sclerotic boundary (Stage 1, n = 6), ONFH with a sclerotic boundary (Stage 2, n = 10), and ONFH with both a sclerotic boundary and <2 mm collapse (Stage 3, n = 35). Four hips without ONFH were used as controls. Stress distribution in each FEM was compared with magnetic resonance imaging (MRI) and computed tomography (CT) results...
August 11, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Dietmar Dammerer, David Putzer, Bernhard Glodny, Johannes Petersen, Ferdi Arrich, Martin Krismer, Rainer Biedermann
PURPOSE: Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication. METHODS: Between 2003 and 2012, a total of 3390 cementless total hip arthroplasties (THA) were performed at our institution. Their medical histories were retrospectively reviewed to identify all patients who received a thin-layer computer tomography (CT) scan of the pelvis including the acetabulum within the first 30 post-operative days...
August 10, 2018: International Orthopaedics
Hong-Man Cho, Jae-Woong Seo, Hyun-Ju Lee, Kyu-Bok Kang, Jung-Ryul Kim, Ho-Wook Wee
OBJECTIVE: There is limited literature concerning the outcomes and role of THA as a surgical option for amputee patients. The aim of this study is to determine the mid-to long-term survival and complication rates of cementless total hip arthroplasty (THA) in patients with contralateral below knee amputations. METHODS: A retrospective review of 54 patients with below knee amputation were perfomed who underwent THA for osteoarthritis of the contralateral hip over a 5-year period between 1999 and 2014...
August 7, 2018: Acta Orthopaedica et Traumatologica Turcica
Yusuke Sasabuchi, Hiroki Matsui, Alan Kawarai Lefor, Kiyohide Fushimi, Hideo Yasunaga
INTRODUCTION: Although early surgery for elderly patients with hip fracture is recommended in existing clinical guidelines, the results of previous studies are inconsistent. The aim of this study was to compare postoperative outcomes of early and delayed surgery for elderly patients with hip fracture. MATERIALS AND METHODS: In this retrospective study using a national inpatient database in Japan, patients aged 65 years or older who underwent surgery for hip fracture between July 2010 and March 2014 were included...
July 27, 2018: Injury
Dan Dragomir-Daescu, Tim Rossman, Asghar Rezaei, Kent D Carlson, David Kallmes, John Skinner, Sundeep Khosla, Shreyasee Amin
Many researchers have used cadaveric fracture tests to determine the relationship between proximal femur (hip) fracture strength and a multitude of possible explanatory variables, typically considered one or two at a time. These variables include subject-specific proximal femur variables such as femoral neck areal bone mineral density (aBMD), sex, age, and geometry, as well as physiological hip fracture event variables such as fall speed and angle of impact. However, to our knowledge, no study has included all of these variables simultaneously in the same experimental dataset...
August 7, 2018: Bone
Xiao Chen, Hai-Tao Xu, Hong-Jun Zhang, Jing Chen
BACKGROUND: Numerous studies have compared suprapatellar (SP) nailing to infrapatellar (IP) nailing for treatment of tibial shaft fractures; however, the best strategy remains controversial. The aim of this meta-analysis is to assess whether SP or IP nailing is more effective for tibial shaft fractures in adults. METHODS: Literature searches of PubMed, Embase, OVID, Cochrane Library, Web of Science, Chinese Biomedical Literature, Wanfang, Weipu Journal, and CNKI databases were performed up to July 2017...
August 2018: Medicine (Baltimore)
D Orwig, M C Hochberg, A L Gruber-Baldini, B Resnick, R R Miller, G E Hicks, A R Cappola, M Shardell, R Sterling, J R Hebel, R Johnson, J Magaziner
BACKGROUND: Incidence of hip fractures in men is expected to increase, yet little is known about consequences of hip fracture in men compared to women. It is important to investigate differences at time of fracture using the newest technologies and methodology regarding metabolic, physiologic, neuromuscular, functional, and clinical outcomes, with attention to design issues for recruiting frail older adults across numerous settings. OBJECTIVES: To determine whether at least moderately-sized sex differences exist across several key outcomes after a hip fracture...
2018: Journal of Frailty & Aging
A V Hauger, A Bergland, K Holvik, A Ståhle, N Emaus, B H Strand
Low bone mineral density (BMD) gives an increased risk of fractures, which can lead to premature death. Can BMD of the wrist predict mortality? BMD consistent with osteopenia and osteoporosis gave a significantly increased risk of death for both men and women in a general population in Tromsø, Norway. INTRODUCTION: To investigate if bone mineral density (BMD) levels of the distal forearm, consistent with osteopenia and osteoporosis, can predict mortality and if grip strength is an effect modifier...
August 9, 2018: Osteoporosis International
R Mazzucchelli, N Crespi Villarias, E Perez Fernandez, M L Durban Reguera, A Garcia-Vadillo, F J Quiros, O Guzon, G Rodriguez Caravaca, A Gil de Miguel
This study examines the association of the levels of different airborne pollutants on the incidence of osteoporotic hip fracture in a southern European region. Association was detected between SO2 and NO2 and hospital admissions due to hip fracture. INTRODUCTION: To examine the short-term effects of outdoor air pollution on the incidence of osteoporotic hip fracture in a southern European region. METHODS: This is an ecological retrospective cohort study based on data obtained from three databases...
August 9, 2018: Osteoporosis International
Kazuki Yamada, Dean K Matsuda, Hitoshi Suzuki, Akinori Sakai, Soshi Uchida
Acetabular bone cyst is usually associated with dysplastic secondary osteoarthritis of the hip joint. Acetabular reorientation osteotomy is one of the most common therapeutic options for treating patients with hip dysplasia. However, it may be too invasive for athletes and can also lead to some complications including intraoperative fracture and postoperative bone necrosis especially in patients with acetabular large bone cysts. Endoscopic shelf acetabuloplasty offers a less invasive option for athletic patients with dysplasia of severity greater than those indicated for isolated hip arthroscopy...
July 2018: Arthroscopy Techniques
Jessica Louise Roberts, Aaron W Pritchard, Michelle Williams, Nikki Totton, Val Morrison, Nafees Ud Din, Nefyn H Williams
OBJECTIVES: To describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared with usual rehabilitation. To compare processes between the two and to collect the views of patients, carers and therapy staff about trial participation. DESIGN: Mixed methods process evaluation in a randomised feasibility study. SETTING: Patient participants were recruited on orthopaedic and rehabilitation wards; the intervention was delivered in the community following hospital discharge...
August 8, 2018: BMJ Open
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