scholarly journals Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment

2021 ◽  
Author(s):  
Johannes Gleich ◽  
Daniel Pfeufer ◽  
Alexander M. Keppler ◽  
Stefan Mehaffey ◽  
Julian Fürmetz ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Gait Speed ◽  
Handgrip Strength ◽  
Weight Bearing ◽  
Proximal Femur Fracture ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Strength Assessment ◽  
Positive Correlation ◽  
Prospective Study Design

Abstract Introduction Treatment of older adult hip fracture patients can be challenging and requires early postoperative mobilisation to prevent complications. Simple clinical tools to predict mobilisation/weight-bearing difficulties after hip fracture surgery are scarcely available and analysis of handgrip strength could be a feasible approach. In the present study, we hypothesised that patients with reduced handgrip strength show incapability to follow postoperative weight-bearing instructions. Materials and methods Eighty-four patients aged ≥ 65 years with a proximal femur fracture (trochanteric, n = 45 or femoral neck, n = 39), who were admitted to a certified orthogeriatric center, were consecutively enrolled in a prospective study design. Five days after surgery (intramedullary nailing or arthroplasty), a standardised assessment of handgrip strength and a gait analysis (via insole forcesensors) was performed. Results Handgrip strength showed positive correlation with average peak force during gait on the affected limb (0.259), postoperative Parker Mobility Score (0.287) and Barthel Index (0.306). Only slight positive correlation was observed with gait speed (0.157). These results were congruent with multivariate regression analysis. Conclusion Assessment of handgrip strength is a simple and reliable tool for early prediction of postoperative mobilisation complications like the inability to follow weight-bearing instructions in older hip fracture patients. Follow-up studies should evaluate if these findings also match with other fracture types and result in personalised adjustment of current aftercare patterns. In addition, efforts should be made to combine objectively collected data as handgrip strength or gait speed in a prediction model for long-term outcome of orthogeriatric patients.

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

Displacement of an Ununited Medial Humeral Condylar Ossification Centre in the Cat

2018 ◽  
Vol 31 (02) ◽  
pp. 153-157
Author(s):  
Kerstin Erles ◽  
Thomas Maddox ◽  
Andy Morris
Keyword(s):  
Weight Bearing ◽  
Distal Humerus ◽  
Acute Onset ◽  
Outcome Evaluation ◽  
Ossification Centre ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Similar Appearance ◽  
The Right

AbstractA 2-year-old cat was presented with the complaint of acute-onset non–weight-bearing lameness of the right forelimb. When examined, the cat was of short stature and had multiple joint and cartilaginous abnormalities suggestive of chondrodysplasia. The cause of the acute lameness was radiographically identified as a displaced osseous fragment from the medial portion of the right humeral condyle. The features of the osseous fragment were consistent with an ununited medial condylar ossification centre of the distal humerus. Furthermore, a nondisplaced ununited ossified fragment of similar appearance and size was present in the contralateral elbow. Surgical treatment by excision of the displaced fragment resulted in a preinjury level of limb function in the long-term outcome evaluation.

Treatment of Osteonecrosis: Treatment by Femoral Osteotomy

1998 ◽  
Vol 8 (3) ◽  
pp. 154-158 ◽  
Author(s):  
F. Menschik ◽  
K.D. Schatz ◽  
R. Kotz
Keyword(s):  
Femoral Head ◽  
Survival Curve ◽  
Weight Bearing ◽  
Harris Hip Score ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Special Cases ◽  
Hip Arthroplasties

The purpose of the use of an osteotomy for the treatment of osteonecrosis (ON) of the femoral head is to move the necrotic segment away from the major load-transmitting area of the acetabulum and to redistribute the weight-bearing forces to articular cartilage that is supported by healthy bone. The most common osteotomies are the varus, valgus, flexion, rotational (Sugioka), and combined osteotomies. Their long term outcome, reported in the literature, is quite controversial. We found a decreasing frequency of flexion osteotomies between 1986 and 1996 performed at our department. In 1977 we started with the Sugioka osteotomy in special cases of femoral head ON (necrotic angle in the AP-view about 90 degree) resulting in a total of 51 cases. Forty-one of them have been analyzed regarding complications, reoperations and Harris Hip Scores. Seventeen of 41 patients developed complications and underwent reoperation. Nevertheless the results according to the Harris Hip Score were satisfactoy (excellent and good in 24 patients fair in 10 and poor only in 7 cases). Independently from the size of the necrosis total hip arthroplasties have been performed in 8 cases. The survival curve of 41 Sugioka osteotomies shows a 50% decrease at 6 years. Due to this fact and the regression in the number of osteotomies of the femur in cases of ON of the hip joint we find in our material that the importance of osteotomies has dramatically decreased in contrast to the excellent results of total hip arthroplasty.

scholarly journals Long-term outcomes after hip fracture in Ireland: a protocol for a systematic review of traditional and grey literature

2021 ◽  
Vol 4 ◽  
pp. 94
Author(s):  
Mary E. Walsh ◽  
Caitriona Cunningham ◽  
Louise Brent ◽  
Bibiana Savin ◽  
Michelle Fitzgerald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Fracture ◽  
Data Collection ◽  
Grey Literature ◽  
Outcome Data ◽  
Inpatient Setting ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome

Background: Hip fracture is experienced by almost 3,500 older people in Ireland annually. The Irish Hip Fracture Database (IHFD), which drives clinical improvements in acute hospitals, aims to allow recording of longer-term outcomes. Feasible and robust methods of data collection need to be identified to inform this activity. The aim of this systematic review is to identify, describe and appraise studies that have collected long-term outcomes after hip fracture in Ireland in the last 15 years and to generate pooled estimates of outcomes if appropriate. Methods: A search of electronic databases (MEDLINE, Embase, Scopus, Web of Science and CINAHL) and grey literature sources will be conducted for journal articles, conference abstracts, academic theses, and reports. Search terms related to hip fracture and Ireland will be included for most sources. The search will be supplemented by email contact with relevant professionals. Observational and interventional studies published between 2005 and 2021 will be included if outcome data were collected in the Republic of Ireland in patients with hip fracture. Outcomes of interest will include data collected after discharge from an inpatient setting or at a fixed time-point greater than 30 days after fracture, hospital admission or surgery. Information relating to study characteristics, description of researchers, data collection methods, patient characteristics and long-term outcomes will be extracted from each study and summarised in tables. Studies will be assessed for risk of bias by two review authors. Where outcomes are sufficiently homogeneous, meta-analyses of estimates will be conducted. Conclusion: Results from this study will inform the planning of further qualitative research to explore barriers and facilitators of long-term outcome collection in Ireland. It will form the basis of education and training for future data collectors in this setting.

scholarly journals Long-term outcome of a child with a proximal femur fracture after high-energy trauma

Injury Extra ◽  
2004 ◽  
Vol 35 (4) ◽  
pp. 35-39 ◽  
Author(s):  
Martin Panzica ◽  
Hans-Christoph Pape ◽  
Rajeev Garapati ◽  
Boris Zelle ◽  
Christian Krettek
Keyword(s):  
Proximal Femur ◽  
Femur Fracture ◽  
High Energy ◽  
Proximal Femur Fracture ◽  
Term Outcome ◽  
Long Term Outcome ◽  
High Energy Trauma

scholarly journals Study of mid and long term outcome of hip fracture in elderly operated within 48 hours versus conservative management

2021 ◽  
Vol 7 (6) ◽  
pp. 1070
Author(s):  
Delis S. Marshall ◽  
Alan S. W. Ch’ng ◽  
Irene Looi
Keyword(s):  
Social Sciences ◽  
Hip Fracture ◽  
Descriptive Analysis ◽  
Post Intervention ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Conservative Group ◽  
Fracture Diagnosis ◽  
The Mean

<p class="abstract"><strong>Background: </strong>Hip fractures are commonly associated with high morbidities and mortalities. This study aimed to determine post-hip fracture outcomes and survival among patients who underwent operation within 48 hours of fracture diagnosis and among those being treated conservatively.</p><p class="abstract"><strong>Methods: </strong>This retrospective cohort study was conducted at the Hospital Seberang Jaya among patients diagnosed with hip fracture from January to December 2016; confirmed clinical and radiological method. Descriptive analysis was conducted using Statistical package for social sciences (SPSS) version 23.</p><p class="abstract"><strong>Results: </strong>The mean (SD) age of the 61 operated patients was 74 (7.7) years and for the 19 conservatively managed patients 79 (8.0) years. At 12 months, 30 (37.5%) of operated ones, required assisted mobility compared to 8 (10%) of conservatively managed patients. Other outcomes comparable between operated and conservative patients at 12 months post-intervention include: ability to feed on own 46 (57.5%) versus 7 (8.8%), able to dress on own, 45 (56.3%) versus 6 (7.5%); able to bathe on own; 43 (53.8%) versus 2 (2.5%), and independently attending to own toilet needs 44 (55.0%) versus 1 (1.3%). Our study revealed, overall survival were comparatively better among those operated to conservative at 12 months; 52 (85%) versus 9 (47.4%). The mortality at 12 months in the conservative group is much higher than operative group.</p><p class="abstract"><strong>Conclusions:</strong> Ambulatory mobility and survival are significantly better at 12 months post-fracture among the operated patients. Hip fracture must be treated as an emergency and its surgical management given priority.</p><p class="abstract"> </p>

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