Surgical treatment of proximal femoral fractures in high-risk geriatric patients under peripheral regional anesthesia

2021 ◽  
Author(s):  
Ronald Seidel ◽  
Eduard Barbakow ◽  
Stefan Schulz-Drost
Keyword(s):  
Surgical Treatment ◽  
High Risk ◽  
Regional Anesthesia ◽  
Geriatric Patients ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures

scholarly journals Infection Versus Hematoma Following Surgical Treatment of Proximal Femoral Fractures in Geriatric Patients

2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Author(s):  
Franz Müller ◽  
Michael Galler ◽  
Christina Roll ◽  
Bernd Füchtmeier
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Treatment ◽  
Geriatric Patients ◽  
Femoral Fractures ◽  
Morbidity And Mortality ◽  
Control Group ◽  
Postoperative Phase ◽  
High Morbidity ◽  
Proximal Femoral Fractures

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

scholarly journals A Case Series and Discussion on Surgical Treatment Strategy for Atypical Proximal Femoral Fractures Associated with Bisphosphonate Use

Cureus ◽  
2018 ◽  
Author(s):  
Brett Rocos ◽  
Thomas Fleming ◽  
Karen Harding ◽  
Mehool Acharya ◽  
Andrew Riddick ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Strategy ◽  
Case Series ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures

scholarly journals Interprosthetic Femoral Fractures Surgical Treatment in Geriatric Patients

2021 ◽  
Vol 12 ◽  
pp. 215145932110137
Author(s):  
Marios Loucas ◽  
Rafael Loucas ◽  
Nico Safa Akhavan ◽  
Patrick Fries ◽  
Michael Dietrich
Keyword(s):  
Surgical Treatment ◽  
Geriatric Patients ◽  
Standard Procedure ◽  
Weight Bearing ◽  
Case Series ◽  
Femoral Fractures ◽  
Full Weight Bearing ◽  
Level Of Evidence ◽  
Type Iv ◽  
Case Series Study

Background: Total hip (THA) and total knee arthroplasty (TKA) are becoming an increasingly standard procedure in the whole world. In conjunction with an aging population and increased prevalence of osteoporosis, proper management of periprosthetic, and interprosthetic fractures is of great interest to orthopedic surgeons. This study aims to report the clinical and radiographic outcomes, complications and reoperations of IFFs in geriatric patients. Methods: A retrospective single-institution case series study was conducted. Between 2011 and 2019, 83 patients underwent surgical treatment for periprosthetic femoral fractures. Thirteen fractures were identified as IFFs. Patient demographics and comorbidities were collected preoperatively, and fractures were classified with the Vancouver and AO unified classification system (AO-UCS). Results: We included 12 patients (13 hips) with IFFs (AO-UCS type IV.3 B (2/13) type IV.3 C (3/13), type IV.3 D (8/13)). The average patient age was 86.54 (range, 79-89) years. There were 10 females and 2 males. Perioperative morbidity has been identified in 10 of the 12 patients, and the 3-month and 1-year mortality were reported in 2 and 3 patients, respectively. Cerclage cables were used in 9 of 12 patients. One of 12 patients showed a local complication, with no documented implant failure or revision. Patients achieved complete union and returned to their preoperative ambulatory status, and full weight-bearing at an average of 5 (range, 2 to 7) months later. Conclusion: Management of IFF can be challenging because these fractures require extensive surgical expertise. Locking plate seems to be a valuable treatment option for geriatric patients with IFFs. Despite the complexity of this type of fracture, the overall complication and revision rate, as well as the radiographic outcome are good to excellent. Level of Evidence: Level III, Therapeutic study.

Surgical Treatment of the Proximal Femoral Fractures in Pediatrics

1999 ◽  
Vol 34 (6) ◽  
pp. 1075
Author(s):  
Hyung Ku Yoon ◽  
Ho Seung Jeon ◽  
Kye Nam Cho ◽  
Seung Ju Jeon ◽  
Woo Sung Kim
Keyword(s):  
Surgical Treatment ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures

scholarly journals No Consequence for Lateral View X-Ray in Displaced Proximal Femoral Fractures in the Elderly

2021 ◽  
Vol 8 ◽  
Author(s):  
Christian Macke ◽  
Maic Werner ◽  
Lambert Herold ◽  
Olaf Krause ◽  
Tilmann Graulich ◽  
...  
Keyword(s):  
Geriatric Patients ◽  
Interobserver Reliability ◽  
Operative Procedure ◽  
Femoral Fractures ◽  
The Elderly ◽  
Lateral View ◽  
X Rays ◽  
Proximal Femoral Fractures ◽  
Operative Strategy ◽  
X Ray

Background: Due to demographic changes, proximal femoral fractures (PFF) in the elderly rise constantly. The standard diagnostic tool is still the X-ray of the pelvis/hip in two planes. Our hypothesis was that the lateral-view X-ray has little influence on classification, planning of the operative procedure, and choice of implant in geriatric patients.Methods: Retrospective analysis of all initial X-rays of PFF in geriatric patients (≥70 years) from May 2018 until August 2019 in a Level I Trauma center. Three experienced consultants categorized the fractures on the ap pelvis view and performed Garden and Pauwels classification as well as a two-staged classification displaced/nondisplaced [for femoral neck fractures (FNF)] or AO Classification [for intertrochanteric fractures (ITF)]. Afterward, they decided the operative strategy as well as implant choice [dynamic hip screw (DHS), intramedullary nail (IMN), or arthroplasty]. After 4 weeks, they categorized all fractures again with now available lateral view X-rays in a different order.Results: Two hundred seven patients (146 female, 61 male; 70.5 vs. 29.5%) with 90 FNF and 117 ITF (43.5 vs. 56.5%) could be included. Age was 84.6 ± 6.9 years. The treatment was in 45 cases DHS, in 82 cases IMN, and for the other 80 cases arthroplasty. The interobserver reliability of the classifications were poor, except for the two-staged classification [Fleiss-κ ap view only = 0.708 (CI 95% 0.604, 0.812) vs. additional lateral = 0.756 (CI 95% 0.644, 0.869)]. Moreover, independent from the classification, there were no significant changes in management and choice of implant with additional lateral view.Conclusions: Regarding our results, we consider the lateral view dispensable for standard X-ray of displaced PFF in geriatric patients. In nondisplaced fractures, it could be added secondary.

scholarly journals Influence of age on delayed surgical treatment of proximal femoral fractures

2015 ◽  
Vol 23 (6) ◽  
pp. 315-318
Author(s):  
Lisiane Pinto Gomes ◽  
Leandra Delfim do Nascimento ◽  
Tulio Vinicius de Oliveira Campos ◽  
Edson Barreto Paiva ◽  
Marco Antonio Percope de Andrade ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Fractures ◽  
Proximal Femoral Fractures
Sign in / Sign up

Export Citation Format

Share Document