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https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#1
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29791709/sub-trochanteric-hip-fracture-following-core-decompression-for-osteonecrosis-in-a-patient-with-a-pre-existing-contralateral-occult-femoral-neck-fracture
#2
Ryan J Berger, Assem A Sultan, Connor Cole, Nipun Sodhi, Anton Khlopas, Michael A Mont
We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791703/biological-intercalary-reconstruction-with-bone-grafts-after-joint-sparing-resection-of-the-lower-limb-is-this-an-effective-and-durable-solution-for-joint-preservation
#3
Francesco Muratori, Francesca Totti, Antonio D'Arienzo, Maurizio Scorianz, Guido Scoccianti, Giovanni Beltrami, Francesco Rosario Campo, Carmine Citarelli, Rodolfo Capanna, Domenico Andrea Campanacci
Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. The authors reviewed a consecutive series of 64 patients treated with joint-sparing intercalary resection and reconstruction with bone grafts...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29790397/higher-cartilage-wear-in-unipolar-than-bipolar-hemiarthroplasties-of-the-hip-at-2-years-a-randomized-controlled-radiostereometric-study-in-19-fit-elderly-patients-with-femoral-neck-fractures
#4
Wender Figved, Stian Svenøy, Stephan M Röhrl, Jon Dahl, Lars Nordsletten, Frede Frihagen
Background and purpose - The use of unipolar hemi-arthroplasties for femoral neck fractures is increasing in some countries due to reports of higher reoperation rates in bipolar prostheses. On the other hand, it has been proposed that bipolar hemiarthroplasties have clinical advantages and less cartilage wear than unipolar hemiarthroplasties. We compared cartilage wear between bipolar and unipolar hemiarthroplasties using radiostereometric analyses (RSA), in patients aged 70 years or older. Patients and methods - 28 ambulatory, lucid patients were randomized to treatment with a unipolar or a bipolar hemiarthroplasty for an acute femoral neck fracture...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29789919/biomarkers-of-muscle-damage-increased-in-anterolateral-compared-to-direct-lateral-approach-to-the-hip-in-hemiarthroplasty-no-correlation-with-clinical-outcome-short-term-analysis-of-secondary-outcomes-from-a-randomized-clinical-trial-in-patients-with-a-displaced
#5
T O Ugland, G Haugeberg, S Svenningsen, S H Ugland, Ø H Berg, A H Pripp, L Nordsletten
In this study, we found elevated levels of serum CK in the anterolateral approach to the hip compared to the direct lateral approach in patients with a displaced femoral neck fracture. No correlation was found between levels of CK and functional outcomes. INTRODUCTION: To compare increase in serum creatine kinase (CK) and its association with functional outcome between the muscle-sparing anterolateral approach and the direct lateral approach to the hip in patients with displaced femoral neck fracture (FNF)...
May 22, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29786824/intramedullary-nail-with-integrated-cephalocervical-screws-in-the-intertrochanteric-fractures-treatment-position-of-screws-in-fracture-stability
#6
Gökhan Kaynak, Mehmet Can Ünlü, Mehmet Fatih Güven, Ozan Ali Erdal, Okan Tok, Hüseyin Botanlıoğlu, Önder Aydıngöz
BACKGROUND: Stable fracture fixation is important in the treatment of intertrochanteric femur (ITF) fractures in the elderly population to prevent the loss of reduction, achieve early mobility, and restore independence. The aim of this study was to present the results of surgical treatment of stable and unstable ITF fractures using a trochanteric antegrade intramedullary nail with two cephalocervical screws in an integrated mechanism (Intertan®; Smith & Nephew, Memphis, TN) and evaluate the relationship between the loss of reduction and screw position in the femoral neck in two planes...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786644/impact-of-bone-fracture-on-ischemic-stroke-recovery
#7
REVIEW
Meng Wei, Haiyian Lyu, Kang Huo, Hua Su
Stroke is one of the most devastating complications of bone fracture, occurring in up to 4% of patients after surgical repair for hip fracture. Bone fracture and ischemic stroke have many common risk factors. The impact of bone fracture on stroke recovery has not drawn much attention in the research field. Bone fracture could occur in stroke patients at different times during the recovery phase, which steepens the trajectory of cognitive decline, greatly affects the quality of life, and causes a heavy burden on healthcare resources...
May 22, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29785747/functional-and-clinical-outcomes-of-patients-aged-younger-and-older-than-85-years-after-rehabilitation-post-hip-fracture-surgery-in-a-co-managed-orthogeriatric-unit
#8
Paolo Mazzola, Patrizia Floris, Domenico Picone, Alessandra Anzuini, Eleni Tsiantouli, Justin Haas, Giuseppe Bellelli, Francesco De Filippi, Giorgio Annoni
AIM: Literature investigating rehabilitation outcomes after hip surgery among individuals aged ≥85 years is sparse. We compared the characteristics and outcomes of patients aged under and over 85 years, and assessed factors potentially associated with rehabilitation success as described by the Barthel Index (BI). METHODS: From 2011 to 2014, we prospectively enrolled 328 patients (n = 152 aged <85 years, n = 176 aged ≥85 years) admitted to an orthogeriatric unit (Sondrio, Italy) with a diagnosis of hip fracture requiring surgical treatment...
May 22, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29785689/the-impact-of-hospital-costing-methods-on-cost-effectiveness-analysis-a-case-study
#9
José Leal, Stefania Manetti, James Buchanan
BACKGROUND: Several methods exist to cost hospital contacts when estimating the cost effectiveness of a new intervention. However, the implications of choosing a particular approach remain unclear. We compare the use of the three main diagnosis-related group (DRG)-based national unit costs in England to determine whether choice of approach can impact on economic evaluation results. METHODS: A cost-utility model was developed to compare secondary fracture prevention models of care for hip fracture patients, using data from large primary and hospital care administrative datasets in England...
May 22, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29784590/prognostic-factors-and-predictive-model-for-in-hospital-mortality-following-hip-fractures-in-the-elderly
#10
J Sanz-Reig, J Salvador Marín, J Ferrández Martínez, D Orozco Beltrán, J F Martínez López, J A Quesada Rico
PURPOSE: The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fracture patients older than 65 years. METHODS: This is a prospective study conducted on 331 hip fracture patients older than 65 years admitted to our hospital from 2011 to 2014. Patients' demographics, prehospitalization residential status, prefracture comorbidity data, anti-aggregant and anticoagulant medication, preoperative hemoglobin value, type of fractures, type of treatments, time to surgery, and complications were recorded...
April 25, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29784241/fracture-probability-assessed-using-frax-%C3%A2-in-elderly-women-with-benign-paroxysmal-positional-vertigo
#11
Takafumi Nakada, Masaaki Teranishi, Yukio Ueda, Michihiko Sone
OBJECTIVE: Patients with benign paroxysmal positional vertigo (BPPV) can have vitamin D deficiency, which is a cause of abnormal bone turnover. Several studies have established a relationship between osteoporosis and BPPV. The World Health Organization Fracture Risk Assessment Tool, widely known as FRAX® (http://www.shef.ac.uk/FRAX), is a computer-based algorithm for assessing fracture risk. No direct comparison has been made between the FRAX scores of patients with BPPV and controls...
May 18, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29784006/secure-corridor-for-infraacetabular-screws-in-acetabular-fracture-fixation-a-3-d-radiomorphometric-analysis-of-124-pelvic-ct-datasets
#12
Stephan Arlt, Hansrudi Noser, Andreas Wienke, Florian Radetzki, Gunther Olaf Hofmann, Thomas Mendel
BACKGROUND: Acetabular fracture surgery is directed toward anatomical reduction and stable fixation to allow for the early functional rehabilitation of an injured hip joint. Recent biomechanical investigations have shown the superiority of using an additional screw in the infraacetabular (IA) region, thereby transfixing the separated columns to strengthen the construct by closing the periacetabular fixation frame. However, the inter-individual existence and variance concerning secure IA screw corridors are poorly understood...
May 21, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29783902/optimal-plate-fixation-of-distal-femoral-fractures-in-the-presence-of-a-well-fixed-cemented-hip-arthroplasty-femoral-stem
#13
Josh Kempthorne, David C Kieser, Cameron G Walker
INTRODUCTION: The requirement for lateral plate fixation in the presence of a hip arthroplasty stem is increasing, yet the optimal plate construct necessary to reduce inter-prosthetic strain and prevent subsequent fractures is unknown. Therefore, the purpose of this study was to determine the optimal position of a lateral femoral plate in relation to a femoral stem. METHODS: We used 4th Generation Composite Sawbones® , a collarless polished cemented femoral stem and a broad Peri-loc™ plate with varying overlap of the stem...
May 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29783670/adult-premenopausal-bone-health-related-to-reproductive-characteristics-population-based-data-from-the-canadian-multicentre-osteoporosis-study-cam-os
#14
Azita Goshtasebi, Claudie Berger, Susan I Barr, Christopher S Kovacs, Tanveer Towheed, K Shawn Davison, Jerilynn C Prior
Amenorrhea is important for women's bone health. However, few have reported reproductive, anthropometric (body mass index [BMI], height) and bone health (areal bone mineral density [BMD], prevalent fractures) in a population-based study. The purposes of this cross-sectional study of women in the randomly-selected Canadian Multicentre Osteoporosis Study (CaM os ) population were: (1) to describe reproductive, demographic, anthropometric and lifestyle variables; and (2) in menstruating women, to relate reproductive and other variables to BMD at the lumbar spine (L1-4, LS), femoral neck (FN) and total hip (TH) sites and to prevalent fragility fractures...
May 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29783641/premature-spinal-bone-loss-in-women-living-with-hiv-is-associated-with-shorter-leukocyte-telomere-length
#15
Shirin Kalyan, Neora Pick, Alice Mai, Melanie C M Murray, Kristen Kidson, Jackson Chu, Arianne Y K Albert, Hélène C F Côté, Evelyn J Maan, Azita Goshtasebi, Deborah M Money, Jerilynn C Prior
With advances in combination antiretroviral therapy (cART), people living with HIV are now surviving to experience aging. Evidence suggests that individuals living with HIV are at greater risk for low bone mineral density (BMD), osteoporosis, and fractures. Better understanding of the pathophysiology of bone health in women living with HIV (WLWH) is important for treatment strategies. The goal of this study was to explore new biological factors linked to low BMD in WLWH. Standardized BMD measures of WLWH were compared to reference values from an unselected population of women from the same geographical region of the same age range...
May 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29782635/effect-of-home-based-rehabilitation-for-hip-fracture-a-meta-analysis-of-randomized-controlled-trials
#16
Desheng Wu, Xiulan Zhu, Shaowei Zhang
BACKGROUND: Home-based rehabilitation following hip fracture may be beneficial; however, the evidence is controversial. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of home-based rehabilitation in patients with hip fracture. METHODS: PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials (RCTs) assessing the effect of home-based rehabilitation for patients with hip fracture were included...
May 21, 2018: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29782454/a-robust-approach-to-implementing-fascia-iliaca-compartment-nerve-blocks-in-hip-fracture-patients
#17
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782453/a-robust-approach-to-implementing-fascia-iliaca-compartment-nerve-blocks-in-hip-fracture-patients
#18
Mark G Williams, Zachary Jeffery, Henry W Corner, John Charity, Marina Quantick, Natalie Sartin
BACKGROUND: A clear imperative exists to optimize the preoperative pain management of hip fracture patients. Increasingly, fascia iliaca compartment blocks (FICBs) are being effectively utilized as an adjunct to oral analgesia in the emergency department. PURPOSE: We investigated the feasibility, safety, and delivery rate when junior doctors and specialist nurses are trained in FICBs delivery, alongside the introduction of a step-by-step proforma. METHODS: We conducted a retrospective study of hip fractures patients presenting preinterventions (n = 138) between October and December 2014 and postinterventions (n = 246) between April and August 2015...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29781820/management-of-pediatric-femoral-neck-fracture
#19
Joseph T Patterson, Jennifer Tangtiphaiboontana, Nirav K Pandya
In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29780621/thromboembolism-prophylaxis-in-orthopaedics-an-update
#20
Dimitrios A Flevas, Panayiotis D Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, Andreas F Mavrogenis
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death.Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%.VTE prophylaxis methods are divided into mechanical and pharmacological...
April 2018: EFORT Open Reviews
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