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JOURNAL ARTICLE
Yao Xiao, Ke Chen, Ke-Wei Tian, Xu Zhou, Min Li, Sen Chen, Zhen-Zhen Zhang
OBJECTIVE: To explore lumbar plexus nerve block combined with general anesthesia in elderly patients undergoing hip operation could improve analgesia effect, reduce consumption of analgesics, prevent inflammatory reaction, and avoid postoperative delirium(POD). METHODS: Totally 200 elderly patients underwent hip fracture surgery from February 2020 to September 2021 were selected and were divided into observation group and control group according to different anesthesia methods...
August 25, 2023: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
#22
RANDOMIZED CONTROLLED TRIAL
Jian-Wen Huang, Yun-Fa Yang, Xiao-Sheng Gao, Zhong-He Xu
OBJECTIVE: Postoperative delirium (POD) is a common complication along with poor prognosis in geriatric intertrochanteric fracture (ITF) patients. However, the prevention and treatment of POD remain unclear. Previous studies have confirmed that POD is essentially a consequence of neuro-inflammatory responses. Dexamethasone is a glucocorticoid with comprehensive anti-inflammatory effects, while a high dose of dexamethasone correlates with many side effects or even adverse consequences...
June 19, 2023: Journal of Orthopaedic Surgery and Research
#23
JOURNAL ARTICLE
Min Li, Chen Chen, Jiang Shen, Linyi Yang
BACKGROUND: Preoperative anemia has been associated with perioperative morbidity and mortality in patients undergoing cardiac and non-cardiac surgery. Preoperative anemia is common in elderly hip fracture patients. The primary objective of the study was to explore the relationship between preoperative hemoglobin levels and postoperative major adverse cardiovascular events (MACEs) in hip fracture patients over 80 years. METHODS: The retrospective study enrolled hip fracture patients over 80 years from January 2015 to December 2021 in our center...
2023: Geriatric Orthopaedic Surgery & Rehabilitation
#24
Sheng-Liang Zhou, Shao-Yun Zhang, Hai-Bo Si, Bin Shen
BACKGROUND: The optimal anesthesia technique for older patients undergoing hip fracture surgery remains controversial. We performed a systematic review and meta-analysis of updated randomized controlled trials (RCTs) to assess whether regional anesthesia was superior to general anesthesia in hip fracture surgery. METHODS: We searched PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials from January 2000 until April 2022. RCTs directly comparing regional and general anesthesia in hip fracture surgery were included in the analysis...
June 13, 2023: Journal of Orthopaedic Surgery and Research
#25
JOURNAL ARTICLE
Henrik C Bäcker, Patrick Elias, Jack Hanlon, John Cunningham, Michael A Johnson, Peter Turner
INTRODUCTION: Spinal fractures in fused spines such as in ankylosing spondylitis or DISH are typically of type B or C fractures where operative treatment is recommended. The mortality rate in non-operatively treated patients is reported to be 51%. The purpose of this study was to investigate the mortality rate, complication rate and demographics of patients following non-operatively treatment in fused spine injuries. METHODS: Between 2019 and 2021, a retrospective study was conducted including all patients who presented to our trauma center with a spinal fracture of a fused spine...
September 2023: Archives of Orthopaedic and Trauma Surgery
#26
JOURNAL ARTICLE
Anna Dorothea Kuhlmann, Claudia Spies, Erika Schulte, Maximilian Jara, Clarissa von Haefen, Mandy Mertens, Laura Anouk Süß, Nathalie Winkler, Gunnar Lachmann, Cornelia Lachmann
OBJECTIVES: Preoperative hypoalbuminaemia is associated with adverse outcome, including increased postoperative mortality in cardiovascular surgery, neurosurgery, trauma and orthopaedic surgery. However, much less is known about the association between preoperative serum albumin and clinical outcomes after liver surgery. In this study, we sought to determine whether hypoalbuminaemia before partial hepatectomy is associated with a worse postoperative outcome. DESIGN: Observational study...
May 18, 2023: BMJ Open
#27
JOURNAL ARTICLE
Edward J Testa, J Alex Albright, Patrick Morrissey, Sebastian Orman, Drew Clippert, Valentin Antoci
INTRODUCTION: Proximal femur fractures have high rates of morbidity, mortality, and perioperative complications. Limiting anesthesia, especially in the elderly population, is a priority from a medical perspective. The goal of the current study is to present a technique of using local anesthetic with monitored anesthesia care (MAC) for the fixation of intertrochanteric (IT) femur fractures with cephalomedullary nailing (CMN), provide early clinical results in a small series of patients, and evaluate the safety, efficiency, and anesthetic efficacy of our technique...
April 10, 2023: Orthopaedics & Traumatology, Surgery & Research: OTSR
#28
JOURNAL ARTICLE
Pedro Magalhães, Mariana Gonçalves, Fátima Silva, Tiago Fernandes, Agripino Oliveira, Rafaela Veríssimo
INTRODUCTION: Orthogeriatrics is the subspecialty of geriatrics that is dedicated to the care of elderly patients with fragility fractures. The Orthogeriatrics Unit of the Vila Nova de Gaia Hospital Centre was the first unit created in Portugal in October 2015, in a co-management model. METHODS: Patients older than 65 years and with femur fractures were admitted to the unit after surgery. The department was run by internists with differentiation in geriatrics, and multidisciplinary support from orthopaedics, physiatrists, physiotherapists, nutritionists, and social workers, as well as rehabilitation nursing...
February 2023: Curēus
#29
JOURNAL ARTICLE
Takeru Tsujimoto, Ryo Itoga, Masahiro Kanayama, Fumihiro Oha, Yukitoshi Shimamura, Masaru Tanaka, Yuichi Hasegawa, Syotaro Fukada, Tomoyuki Hashimoto, Masahiko Takahata, Norimasa Iwasaki
OBJECTIVE: Although the number of elderly patients requiring lumbar fusion for lumbar degenerative disorders has increased over time, the postoperative outcomes of lumbar fusion in very elderly patients (> 85 years) remains unknown. This study aimed to evaluate the comprehensive outcomes of lumbar fusion in elderly patients older than 85 years with mid-term follow-up. METHODS: The authors retrospectively researched patients older than 85 years who underwent single- or double-level posterior lumbar interbody fusion or transforaminal lumbar interbody fusion from 2012 to 2019...
March 24, 2023: Journal of Neurosurgery. Spine
#30
REVIEW
D Tandon, K Curlewis, A Vusirikala, P Subramanian, A Patel
INTRODUCTION: Electronic pathways (e-pathways) and digital systems are novel interventions with several uses in healthcare, ranging from clinical decision support systems to checklists for care delivery. Their application in the management of neck of femur (NOF) fractures is evolving and they may play a key role in facilitating improvements in care delivery. The primary aim of this review was to outline the impact of e-pathways/digital systems on NOF fracture outcomes. METHODS: A systematic literature search was performed using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines...
March 16, 2023: Annals of the Royal College of Surgeons of England
#31
JOURNAL ARTICLE
Andrew J Hall, Nick D Clement, Robert S Kay, Rose S Penfold, Alasdair M J MacLullich, Timothy O White, Andrew D Duckworth
PURPOSE: The primary aim was to evaluate the impact of COVID-19 on frailty in patients surviving a hip fracture. Secondary aims were to assess impact of COVID-19 on (i) length of stay (LoS) and post-discharge care needs, (ii) readmissions, and (iii) likelihood of returning to own home. METHODS: This propensity score-matched case-control study was conducted in a single centre between 01/03/20-30/11/21. A 'COVID-positive' group of 68 patients was matched to 141 'COVID-negative' patients...
March 11, 2023: Musculoskeletal Care
#32
Michal P Pelczar, Andrej M Nowakowski
INTRODUCTION: Tuberculous coxitis accounts for about 15% of all osteoarticular tuberculosis cases and is the second most common after spinal tuberculosis. In extensive cases, Girdlestone resection arthroplasty is an option for primary surgical treatment followed in the course of time, with total hip arthroplasty (THR) to increase function. However, the remaining bone stock is generally poor. In these cases, the Wagner cone stem offers good pre-conditions for bone restoration even seven decades after Girdlestone, as presented here...
September 2022: Journal of Orthopaedic Case Reports
#33
JOURNAL ARTICLE
Jing Ling, Yi-Ji Tu, Shi-Cheng Wang, Jun-Hui Zhang, Zheng-Lin Di
OBJECTIVE: To investigate the clinical efficacy of unicompartmental knee arthroplasty (UKA) in the treatment of knee osteoarthritis in patients over 75 years old. METHODS: The clinical efficacy of primary fixed platform UKA in patients with osteoarthritis, was retrospectively analyzed from October 2014 to November 2020. Age, body mass index (BMI), range of motion (ROM), preoperative joint function score, the quality of life score and other preoperative indicators were measured by propensity score matching (PSM)...
February 25, 2023: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
#34
JOURNAL ARTICLE
Kimberly L Stevenson, Matthew K Stein, George W Fryhofer, Sean Looby, Derek Donegan, Samir Mehta
INTRODUCTION: The aim of this study was to determine whether the administration of liposomal bupivacaine decreased opioid use and delirium in patients sustaining a hip fracture. METHODS: A retrospective review of patients with hip fracture from September 2018 to October 2019 was performed through our institution's hip fracture registry. A liposomal bupivacaine cocktail was administered intraoperatively. Opioid requirement was determined for postoperative days 1, 2, and 3...
March 1, 2023: Journal of the American Academy of Orthopaedic Surgeons
#35
JOURNAL ARTICLE
Ahmed K Emara, Precious C Oyem, Alexandra Ferre, Jessica Churchill, Daniel Grits, Mitchell Ng, Xuankang Pan, Matthew Nagy, Derrick Obiri-Yeboah, Robert M Molloy, Nicolas S Piuzzi
OBJECTIVE: We aimed to characterize the association between BMI as a continuous variable and 30-day postoperative outcomes following hip fracture surgery through:1)30-day readmission and reoperation; 2)local wound-related; and 3)systemic complications. METHODS: The National Surgical Quality Improvement Program(NSQIP) database(January 2016-December,2019) was queried for patients undergoing hip fracture ORIF. Baseline patient demographics, comorbidities, and patient outcomes were recorded...
February 14, 2023: Journal of Orthopaedic Trauma
#36
JOURNAL ARTICLE
Tamara Backhouse, Chris Fox, Simon P Hammond, Fiona Poland, Vicki McDermott-Thompson, Bridget Penhale, Jane L Cross
OBJECTIVES: To determine how, and under what circumstances, the PERFECT-ER intervention was implemented in five acute hospital wards and impacted on staff practices and perceptions. DESIGN: Mixed methods process evaluation (undertaken between 2016 and 2018). SETTING: Five acute hospital wards across three different UK regions. PARTICIPANTS: Patients (n=3) admitted to acute wards with hip fracture and cognitive impairment, their relatives (n=29) and hospital staff (n=63)...
February 3, 2023: BMJ Open
#37
JOURNAL ARTICLE
Satoshi Nori, Kota Watanabe, Kazuki Takeda, Junichi Yamane, Hitoshi Kono, Noriaki Yokogawa, Takeshi Sasagawa, Kei Ando, Hiroaki Nakashima, Naoki Segi, Toru Funayama, Fumihiko Eto, Akihiro Yamaji, Takeo Furuya, Atsushi Yunde, Hideaki Nakajima, Tomohiro Yamada, Tomohiko Hasegawa, Yoshinori Terashima, Ryosuke Hirota, Hidenori Suzuki, Yasuaki Imajo, Shota Ikegami, Masashi Uehara, Hitoshi Tonomura, Munehiro Sakata, Ko Hashimoto, Yoshito Onoda, Kenichi Kawaguchi, Yohei Haruta, Hiroshi Uei, Hirokatsu Sawada, Kazuo Nakanishi, Kosuke Misaki, Hidetomi Terai, Koji Tamai, Eiki Shirasawa, Gen Inoue, Katsuhito Kiyasu, Yoichi Iizuka, Eiji Takasawa, Haruki Funao, Takashi Kaito, Toshitaka Yoshii, Masayuki Ishihara, Seiji Okada, Shiro Imagama, Satoshi Kato
BACKGROUND: Although previous studies have demonstrated the advantages of early surgery for traumatic spinal cord injury (SCI), the appropriate surgical timing for cervical SCIs (CSCIs) without bone injury remains controversial. Here, we investigated the influence of relatively early surgery within 48 h of injury on the neurological recovery of elderly patients with CSCI and no bone injury. METHODS: In this retrospective multicenter study, we reviewed data from 159 consecutive patients aged ≥65 years with CSCI without bone injury who underwent surgery in participating centers between 2010 and 2020...
January 29, 2023: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
#38
Dimitrios Adamis, Piet Eikelenboom
BACKGROUND: The relationship between delirium and low levels of insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We hypothesised that low levels of IGF-1 are a predisposing factor for delirium in medical and abdominal surgical cohorts, in contrast to other surgical cohorts. AIMS: Systematic review and meta-analysis investigating the association between peripheral levels of IGF-1 and delirium in medical and surgical patients to explore if there are distinct patterns of associations by using subgroup meta-analysis...
2022: Dementia and Geriatric Cognitive Disorders
#39
JOURNAL ARTICLE
Qin Xie, Xiao-Bo Liu, Guang-Wu Jing, Xue Jiang, Hong Liu, Bao-Liang Zhong, Yi Li
OBJECTIVE: The low recognition rate of postoperative delirium has gradually aroused clinical attention in China. The present study was to investigate the impact of consultation-liaison psychiatry on postoperative delirium in elderly hip fracture patients. METHODS: From March 2012 to September 2013, 89 patients with hip fractures hospitalized in Wuhan Mental Health Center were included in this prospective study as the consultation-liaison group. A total of 81 patients selected from August 2010 to February 2012 were defined as the conventional group...
January 3, 2023: Orthopaedic Surgery
#40
JOURNAL ARTICLE
Jing Liu, Meinv Liu, Jianli Li, Junfang Rong
INTRODUCTION: Postoperative delirium (POD) acts as a common complication in older patients after surgery, accompanied by longer recovery time, prolonged hospital stay, increased hospitalisation costs, etc. Therefore, it is urgent to reduce POD by implementing some intervention strategies. Early identification of associated risk factors was regarded as an effective method to lower the incidence of POD. Currently, the incidence and risk factors of POD have been widely investigated in orthopaedic and cardiac surgery, while remain scarce in thoracic and abdominal surgery...
December 29, 2022: BMJ Open
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