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Ross Coomber, Matthew Porteous, Matthew J W Hubble, Martyn J Parker
When treating a hip fracture with a total hip replacement (THR) the surgical technique may differ in a number of aspects in comparison to elective arthroplasty. The hip fracture patient is more likely to have poor bone stock secondary to osteoporosis, be older, have a greater number of co-morbidities, and have had limited peri-operative work-up. These factors lead to a higher risk of complications, morbidity and perioperative mortality. Consideration should be made to performing the THR in a laminar flow theatre, by a surgeon experienced in total hip arthroplasty, using an anterolateral approach, cementing the implant in place, using a large head size and with repair of the joint capsule...
October 2016: Injury
Bodhi Wimalasena, Roger Harris
AIMS: The aims of this audit were to collect the Minimum Data Set outlined by the Australia New Zealand Hip Fracture Registry (ANZHFR), assess patient characteristics, analyse process of care, and evaluate how this compares to NICE guidelines for hip fracture care, as well as to Auckland Hospital data from 2007. METHOD: Retrospective case record audit of patients with fractured neck of femur aged 65 years and over admitted under Orthopaedics over a 4-month period in 2013...
2016: New Zealand Medical Journal
Genni Lynch, Kate Bell, Debra Long, Liz Burmeister
INTRODUCTION: Patients presenting to hospital with a fragility hip fracture are routinely catheterized in the emergency department. Studies have found that the duration of catheterization is the greatest and most important risk factor for developing a urinary tract infection. Whilst there is a considerable body of evidence around correct techniques for insertion of urinary catheters, there appears to be little evidence as to the timing of their removal. AIM OF THE STUDY: To describe the current practice of indwelling catheter (IDC) removal post operatively in the fragility hip fracture patient and to identify factors associated with the successful removal of IDCs post operatively in the same cohort of patients...
March 4, 2016: International Journal of Orthopaedic and Trauma Nursing
Stephen T Isbel, Maggie I Jamieson
The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation...
February 2, 2016: Dementia
Khosrow Adeli, Victoria Higgins, Michelle Nieuwesteeg, Joshua E Raizman, Yunqi Chen, Suzy L Wong, David Blais
BACKGROUND: Biological covariates such as age and sex can markedly influence biochemical marker reference values, but no comprehensive study has examined such changes across pediatric, adult, and geriatric ages. The Canadian Health Measures Survey (CHMS) collected comprehensive nationwide health information and blood samples from children and adults in the household population and, in collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), examined biological changes in biochemical markers from pediatric to geriatric age, establishing a comprehensive reference interval database for routine disease biomarkers...
August 2015: Clinical Chemistry
Juliana Hack, Christopher Bliemel, Steffen Ruchholtz, Benjamin Bücking
Hip fractures are among the most common fractures in elderly people. The annual number of femoral fractures is even expected to increase because of an aging society. Due to the high number of comorbidities, there are special challenges in treating geriatric hip fracture patients, which require a multidisciplinary management. This includes surgical treatment allowing full weight bearing in the immediate postoperative period, osteoporosis treatment and falls prevention as well as an early ortho-geriatric rehabilitation program...
April 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
B Subramanian, H Parsons, P Finner, R Townsend
Following a cluster of two patients with identical strains of Clostridium perfringens prosthetic joint infections on an ortho-geriatric ward in a teaching hospital in England, investigations were conducted into infection control practices. It emerged that empathy dolls were being used to help alleviate agitation in dementia patients; this had been introduced without consultation with the infection prevention and control team. Environmental testing of the doll pre and post laundry at different temperatures helped to establish the types and numbers of organisms present...
May 2014: Journal of Hospital Infection
Elsa Vitale, Angela Notarnicola, Silvio Tafuri, Giovanni Vicenti, Maria Cassano, Biagio Moretti
The Orthopedic Multidimensional Prognostic Index (Ortho-MPI) was performed and validated in order to ameliorate the decision-making process as regards the elderly with hip or neck femur fractures. A retrospective study was performed. 95 patients 65 years old and over with a diagnosis of hip or femur fracture were enrolled. A standardized comprehensive orthopedic geriatric assessment was performed. It included information on: depressive symptoms, functional and instrumental activities of daily living, cognitive and nutritional status, laboratory tests, risk of pressure sore, comorbidities and comorbidity...
January 2014: Archives of Gerontology and Geriatrics
Gary Ginsberg, Abraham Adunsky, Iris Rasooly
BACKGROUND: The economic burden associated with hip fractures calls for the investigation of innovative new cost-utility forms of organisation and integration of services for these patients. OBJECTIVE: To carry out a cost-utility analysis integrating epidemiological and economic aspects for hip fracture patients treated within a comprehensive orthogeriatric model (COGM) of care, as compared with standard of care model (SOCM). DESIGN: A demonstration study conducted in a major tertiary medical centre, operating both a COGM ward and standard orthopaedic and rehabilitation wards...
November 2013: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Lucy Fergus, Greer Cutfield, Roger Harris
BACKGROUND: The process of care of older patients with fractured neck of femur at Auckland City Hospital has recently changed with selected patients "fast-tracked" as soon as possible postoperatively to a specialised Older People's Health (OPH) ward. AIMS: The aims of this study were: to evaluate patient characteristics; to analyse process of care; to compare outcomes in those "fast-tracked" patients with those receiving usual care; and to compare this information with previous data from Auckland City Hospital and other centres in New Zealand...
June 24, 2011: New Zealand Medical Journal
C Kammerlander, T Roth, S M Friedman, N Suhm, T J Luger, U Kammerlander-Knauer, D Krappinger, M Blauth
In the fast-growing geriatric population, we are confronted with both osteoporosis, which makes fixation of fractures more and more challenging, and several comorbidities, which are most likely to cause postoperative complications. Several models of shared care for these patients are described, and the goal of our systematic literature research was to point out the differences of the individual models. A systematic electronic database search was performed, identifying articles that evaluate in a multidisciplinary approach the elderly hip fracture patients, including at least a geriatrician and an orthopedic surgeon focused on in-hospital treatment...
December 2010: Osteoporosis International
Doug Johnson-Greene, Pegah Touradji, Lindsay C Emmerson
Screening tests for memory can be administered more quickly than standard tests of memory. They can be particularly useful with patients with acute medical illness or with the elderly who are unable to tolerate complex or lengthy memory testing, such as patients with acute stroke. However, screening measures for memory often lack validation and may have significant psychometric limitations. The purpose of this study was to validate and determine the psychometric properties of the Three Cities Test (TCT), a short test of memory that uses a selective reminding paradigm and the names of well-known cities as stimuli...
September 2009: Topics in Stroke Rehabilitation
Antonella Barone, Andrea Giusti, Monica Pizzonia, Monica Razzano, Mauro Oliveri, Ernesto Palummeri, Giulio Pioli
OBJECTIVE: To evaluate baseline characteristics and in-hospital factors associated with nonadherence with an immediate weight-bearing and early ambulation (IWB-EA) program after hip fracture (HF) surgery. DESIGN: Prospective inception cohort study. SETTING: Ortho-geriatric unit in an acute care hospital. PARTICIPANTS: Older adults (N=469) admitted with an osteoporotic HF who underwent surgery. INTERVENTIONS: Immediate weight-bearing and assisted ambulation training on the first postoperative day (all patients)...
September 2009: Archives of Physical Medicine and Rehabilitation
John H Thwaites, Fazal Mann, Nigel Gilchrist, Chris Frampton, Alastair Rothwell, Richard Sainsbury
AIMS: To evaluate the effect of shared care between geriatricians and orthopaedic surgeons as a model of care for older patients with hip fractures. METHODS: All patients over the age of 65 years are under the shared care of an orthopaedic surgeon and geriatrician (the Ortho-Medicine Service) when they are admitted to the Orthopaedic Service, Christchurch Hospital, New Zealand. This retrospective case records audit includes all patients over the age of 65 years with hip fracture admitted to this service over a 6-month period from December 2002 to June 2003...
May 6, 2005: New Zealand Medical Journal
R Wakeman, P D Sheard, G H Jenner
No abstract text is available yet for this article.
July 2004: Journal of Bone and Joint Surgery. British Volume
A Edlund, M Lundström, G Lundström, B Hedqvist, Y Gustafson
The incidence of delirium, its predisposing factors, clinical profile, associated symptoms and consequences were investigated in 54 consecutive patients, 19 men and 35 women, mean age 77.1 years, admitted to an 'ortho-geriatric unit' with femoral neck fractures. The incidence of postoperative delirium was 15/54 (27.8%) and a logistic regression model found that dementia and a prolonged waiting time for the operation increased the risk of postoperative delirium. Delirium during the night was most common but in 5 patients the delirium was worst in the morning...
September 1999: Dementia and Geriatric Cognitive Disorders
P R Street, T Hill, L C Gray
An ortho-geriatric service operated by Bundoora Extended Care Centre and Preston and Northcote Community Hospital was established in 1991 to improve rehabilitative care and discharge planning of elderly hip fracture patients. 123 patients were treated during the first year of the service's operation. There was a 25 per cent reduction in the acute hospital length of stay, an increased proportion of patients discharged home and a decreased need for post-acute rehabilitation in comparison to figures for 1989, leading to a substantial reduction in the total number of bed-days occupied in the hospital system as a whole by hip fracture patients...
1994: Australian Health Review: a Publication of the Australian Hospital Association
J C Brocklehurst, K Andrews
The three main styles of geriatric practice in the UK at present are: combined acute and rehabilitation with separate long-stay wards (37.5%), separate acute, rehabilitation and long-stay wards (24.4%) and combined acute, rehabilitation and long-stay wards (21.1%). The first of these has the highest bed/population ratio, the second the highest discharge rate per bed and per population and the third has the highest consultant/bed ratio. There is some relationship between style of practice and geographical characteristics of the area...
January 1985: Age and Ageing
H Hofmann, C Kunz
294 health care workers from 21 different departments were tested for hepatitis C antibodies by means of the Ortho ELISA test. Only six (2%) were found positive. Health care workers having direct contact with the patient, such as doctors and nurses, seem to be at a higher risk of infection than those with only indirect contact, such as laboratory technicians and cleaning personnel. In the geriatric ward the risk is possibly slightly higher than in other departments. However, in general risk of infection with HCV for health care workers seems to be low...
September 1990: Infection
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