480 Preoperative Templating in Hip Hemiarthroplasty Improves Femoral Offset and Function

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Saleem ◽  
S Parikh ◽  
T Parratt ◽  
M Loeffler
Keyword(s):  
Clinical Outcomes ◽  
Fracture Dislocation ◽  
Neck Of Femur ◽  
Hip Hemiarthroplasty ◽  
Preoperative Templating ◽  
Percentage Difference ◽  
Group Data ◽  
Significant Difference ◽  
Neck Of Femur Fracture ◽  
And Function

Abstract The use of preoperative templating for hip hemiarthroplasty increases the likelihood of successfully restoring offset. This study sought to identify whether templating improves radiographic and clinical outcomes in this group. Data belonging to all patients that underwent hip hemiarthroplasty between March 2018 and March 2019 were collected. The patients were grouped based on whether or not their preoperative images were templated. Radiographs were studied retrospectively to calculate preoperative and postoperative offset and LLD for each patient. The clinical outcomes that were measured included the rate of periprosthetic fracture, dislocation and contra-lateral neck of femur fracture for each group. Data was analysed by SPSS. There were 208 patients of which 72 were templated and 136 not templated. The percentage difference between the preoperative and postoperative offset was lower in the templated group (p < 0.05). There was no significant difference in radiographic LLD between the two groups. There was no significant difference in the clinical outcomes between the two groups. A significantly closer restoration to the original offset was achieved with preoperative templating, which is likely to improve function in this group. There were no significant differences in the other clinical outcomes between the two groups.

scholarly journals Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: case-control study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Guangheng Xiang ◽  
Xiaoyu Dong ◽  
Xingan Jiang ◽  
Leyi Cai ◽  
Jianshun Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Clinical Outcomes ◽  
Open Reduction ◽  
Patient Characteristics ◽  
Fracture Dislocation ◽  
Surgical Trauma ◽  
Type Ii ◽  
Fixation Group ◽  
Significant Difference ◽  
Minimally Invasive Fixation

Abstract Objective To investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation. Methods We reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared. Results There was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision, and the hospital stay were significantly shorter in the percutaneous cross screws internal fixation group. No significant difference on Matta scores and Majeed scores between the two groups. The open reduction and internal fixation group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort, and pain. Conclusion Percutaneous cross screws internal fixation for Day II type pelvic crescent fracture-dislocation was safe and effective. Minimally invasive fixation had the advantages of short operation and hospitalization time, less intraoperative bleeding, and surgical trauma.

scholarly journals Predictors and outcomes of treatment in hip hemiarthroplasty dislocation

2014 ◽  
Vol 96 (6) ◽  
pp. 446-451 ◽  
Author(s):  
KMI Salem ◽  
OA Shannak ◽  
BE Scammell ◽  
CG Moran
Keyword(s):  
Closed Reduction ◽  
Definitive Treatment ◽  
Initial Attempt ◽  
Neck Of Femur ◽  
Hip Hemiarthroplasty ◽  
Fourfold Increase ◽  
Early Exploration ◽  
Dislocation Group ◽  
Neck Of Femur Fracture ◽  
Complications And Mortality

Introduction Dislocation following hip hemiarthroplasty (HHA), its incidence, predictors, treatment outcomes and mortality were investigated in a single centre series. Methods The prospectively collected data on neck of femur fracture admissions compiled over 11 years were reviewed. Place of residence, place of fall, past medical history, intraoperative factors (grade of surgeon, delay in surgery, type of implant and operative time), postoperative complications and mortality were compared between patients who suffered a dislocation and those who did not. In the dislocation group, the mean number of dislocations, reduction method, type and fate of implant, and mortality were investigated. Results Prospective data on 8,631 admissions were collected; 41% of these were managed with a HHA. The dislocation rate was 0.76%. A delay in surgery of >24 hours was associated with a fourfold increase in the dislocation risk. The majority (81%) of dislocations occurred in the first six weeks and closed manipulation was the definitive treatment in only 23% of the cases. The mortality rate was not increased following HHA dislocation. Conclusions The delay in surgery was the most important predictor of HHA dislocation. Closed reduction was associated with a high failure rate. While an initial attempt at closed reduction for a first dislocation is recommended, for redislocators, we recommend early exploration/revision as an alternative to repeat manipulations.

scholarly journals 601 The Effect of the COVID-19 Pandemic on Hip Fracture Mortality in The South West of England

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Spolton-Dean ◽  
B Kent ◽  
T Ball ◽  
R Middleton ◽  
C Marusza ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Perioperative Mortality ◽  
Neck Of Femur ◽  
Significant Drop ◽  
Data Set ◽  
Urgent Surgery ◽  
Significant Difference ◽  
Neck Of Femur Fracture ◽  
Hip Fracture Mortality ◽  
Post Hoc

Abstract Aim High perioperative mortality rates in surgical patients suffering concomitant COVID-19 infection have contributed to a fall in elective and urgent surgery. However, data and debate have centred around post hoc infected cases, without the context of the rest of the surgical cohort, and without comparable historical control groups. We aimed to address this by studying patients with a neck of femur fracture. This common condition has a stable incidence with good prospective data collected routinely for the National Hip Fracture Database (NHFD). Method We analysed NHFD data for all hospitals within our region over a 3-month period, covering the height of the first outbreak and compared this with the same months in 2019. Results The incidence of hip fracture was stable (463 in 2019, 448 in 2020). 30-day mortality was 6.26% in 2019 and 7.14% in 2020 (p = 0.595). In the second cohort, 14 patients tested positive for COVID-19 perioperatively. Of these, 3 died (21%) compared to 29 who tested negative (p < 0.001). Mean time to operation reduced by 1.90 hours, with a significant drop in patients waiting over 36 hours (190 to 85, p < 0.001). There were no significant differences between gender, ASA grade or pre-operative AMTS. Conclusions We have confirmed high perioperative mortality for those with COVID-19 infection but have not shown a statistically significant difference in overall mortality from hip fracture during the initial phase of the pandemic. We argue from this data set that the hypothetical risk of surgery during this pandemic may have been overestimated.

OUTCOME COMPARISON OF TREATMENT BASICERVICAL NECK OF FEMUR FRACTURE USING HEMIARTHROPLASTY VERSUS DYNAMIC HIP SCREW

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Manpreet Singh ◽  
Anurag Dhaker ◽  
Pradeep Kumar Mundotiya
Keyword(s):  
Femur Fracture ◽  
Age Groups ◽  
Clinical Score ◽  
Dynamic Hip Screw ◽  
Neck Of Femur ◽  
Medical College ◽  
Significant Difference ◽  
Outcome Comparison ◽  
Hip Screw ◽  
Neck Of Femur Fracture

Background: The present study was conducted to compare outcome of hemiarthroplasty with dynamic hip screw for basicervical neck of femur fracture. Methods: Hospital based, randomized prospective, comparative interventional study conducted on Basicervical neck of femur fracture cases attending with orthopaedics department of S.M.S. Medical College and Hospital, Jaipur (Rajasthan, India) Results: As per the post operative complications in Hemiarthroplasty and DHS groups respectively, no significant difference was observed among the group. As per the age groups clinical score (merle's d aubigne), at 6m and 12 m Group H was better than group D. As per average functional outcome at 3,6 ,12months. Score improved with the time. Conclusion: We concluded that Hemiarthroplastymay allow better restoration of function and should be favoured for treatment of fracture neck of femur in patients that meet the indications for surgery whenever the technical competence and facilities exist. Keywords: Femur, Hemiarthroplasty, DHS

scholarly journals Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for pelvic Day type II crescent fracture-dislocation: Case-control study

2020 ◽  
Author(s):  
Guangheng Xiang ◽  
Xiaoyu Dong ◽  
Xingan Jiang ◽  
Leyi Cai ◽  
Jianshun Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Clinical Outcomes ◽  
Open Reduction ◽  
Patient Characteristics ◽  
Fracture Dislocation ◽  
Surgical Trauma ◽  
Type Ii ◽  
Fixation Group ◽  
Significant Difference ◽  
Minimally Invasive Fixation

Abstract Objective: To investigate the clinical outcomes of percutaneous cross screws internal fixation for pelvic Day type II crescent fracture-dislocation.Methods: We reviewed 66 consecutive patients undergoing surgical treatment for Day type II crescent fracture-dislocation from June 2005 to December 2017. Percutaneous cross screws internal fixation was performed in 40 patients, and open reduction and internal fixation was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared.Results: There was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision and the hospital stay were significantly shorter in the percutaneous cross screws internal fixation Group. No significant difference on Matta scores and Majeed scores between the two groups. The open reduction and internal fixation Group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort and pain.Conclusion: Percutaneous cross screws internal fixation for Day Ⅱ type pelvic crescent fracture-dislocation was safe and effective. Minimally invasive fixation had the advantages of short operation and hospitalization time, less intraoperative bleeding and surgical trauma.

scholarly journals Comparison of percutaneous cross screw fixation versus open reduction and internal fixation for Day type II crescent fracture-dislocation: Case-control study

2020 ◽  
Author(s):  
Guangheng Xiang ◽  
Xiaoyu Dong ◽  
Xingan Jiang ◽  
Leyi Cai ◽  
Jianshun Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Clinical Outcomes ◽  
Open Reduction ◽  
Operation Time ◽  
Patient Characteristics ◽  
Fracture Dislocation ◽  
Surgical Trauma ◽  
Type Ii ◽  
Significant Difference ◽  
Minimally Invasive Fixation

Abstract Objective: To investigate the clinical outcomes of percutaneous cross screws internal fixation (PCSIF) for Day type II crescent fracture-dislocation (CFD). Methods: We reviewed 66 consecutive patients undergoing surgical treatment for Day type II CFD from June 2005 to December 2017. PCSIF was performed in 40 patients, and open reduction and internal fixation (ORIF) was performed in 26 patients. The patient characteristics, surgical complications, radiographic and clinical outcomes and were compared. Results: There was no statistically difference on the mean time from injury to surgery between the two groups. The time of operation, the amount of blood loss, the length of incision and the hospital stay were significantly shorter in the PCSIF Group. No significant difference on Matta scores and Majeed scores between the two groups. The ORIF Group resulted in a higher rate of intraoperative hemorrhage, nerve injury, discomfort and pain. Conclusion: PCSIF for Day Ⅱ type pelvic CFD was safe and effective. Minimally invasive fixation had the advantages of short operation time and hospitalization time, less intraoperative bleeding and less surgical trauma.

scholarly journals 730 Is The Total Hip Arthroplasty For Hip Fracture Comparable With Matched Elective Cohort ? A Prospective Study

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T K Tan ◽  
J W Lim ◽  
N Alkandari ◽  
D Ridley ◽  
S Sripada ◽  
...  
Keyword(s):  
Pain Score ◽  
Functional Outcomes ◽  
Clinical Indication ◽  
Harris Hip Score ◽  
Neck Of Femur ◽  
Total Hip ◽  
Significant Difference ◽  
Modified Harris Hip Score ◽  
Neck Of Femur Fracture ◽  
A Prospective Study

Abstract Aim Total hip replacement (THR) has been effective in managing osteoarthritis but its effectiveness in managing neck of femur fracture (#NOF) is debatable due to higher risk of morbidity and mortality. We aimed to review the selection criteria for trauma THR and to compare the functional outcomes and complication profiles of trauma THR cohort with elective THR cohorts. Method we prospectively reviewed patients undergoing THR for #NOF with follow-up. The functional outcomes, any further complications-related admissions and death within a year were noted for subsequent analysis. All the patients and data collected were subsequently matched with the elective cohort. Results Forty-one matched cases were included in our study. The Modified Harris Hip Score (mHHS) was significantly lower pre-operatively in elective cohort (41.4±14.3 VS 60.3±22.2, P < 0.001) and achieved significantly higher score than trauma cohort 1-year post operatively (88.2±10.9 VS 82.6±12.7, P = 0.029). As for the mHHS Function, the trauma cohort achieved similar value with the pre-operative score post-operatively, and no significant difference was witnessed between the trauma and elective cohort post-operatively (35.1±7.4 VS 37.6±7.7, P = 0.142). mHHS Pain score was significantly higher in trauma cohort pre-operatively (19.8±15.3 VS 12.7±6.3, P = 0.034), but the score was significantly higher than trauma cohort 1-year postoperatively (42.7±4.4 VS 40.7±7.7, P = 0.027). Both cohorts had similar complication rate. Conclusions Our study further justified the clinical indication of THR for #NOF. With careful selection, trauma THR can achieve similar HHS function and better pain score. Further randomized controlled trials are warranted to justify our findings.

scholarly journals No differences in clinical outcomes and cartilage repair between opening wedge and closed wedge high tibial osteotomies at short-term follow-up: A retrospective case series analysis

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110203
Author(s):  
Tomotaka Akamatsu ◽  
Ken Kumagai ◽  
Shunsuke Yamada ◽  
Shuntaro Nejima ◽  
Masaichi Sotozawa ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cartilage Repair ◽  
Multivariate Logistic Regression Analysis ◽  
Tibial Osteotomy ◽  
Cartilaginous Tissue ◽  
Opening Wedge ◽  
Closed Wedge ◽  
Significant Difference ◽  
And Function ◽  
And Cartilage

Purpose: The aim of this study was to assess differences in clinical outcomes and postoperative cartilage repair between opening wedge high tibial osteotomy (OWHTO) and closed wedge HTO (CWHTO) for medial osteoarthritis (OA) of the knee. Methods: A total of 90 knees of 76 patients who underwent OWHTO (45 knees of 40 patients) and CWHTO (45 knees of 36 patients) was followed-up for 2 years. Cartilage repair at the medial compartment was arthroscopically classified into the following stages: Stage 1 (no reparative change); Stage 2 (partial coverage with white cartilaginous tissue); and Stage 3 (full coverage with white cartilaginous tissue). Clinical outcomes were assessed using Knee Society scores, and radiographic assessment was carried out by anatomical femorotibial angle (aFTA). Results: Regarding preoperative OA grade, varus alignment, and function score, CWHTO patients showed more advanced OA status than OWHTO patients. Knee scores and function scores were significantly improved after surgery with both HTO procedures (P < 0.05), with no significant difference between the two procedures. Cartilage repair of stage 2 or 3 was found in more than 80% of the subjects in the medial femoral condyle and more than 60% in the medial tibial condyle. However, there were no significant differences between the two HTO procedures. Multivariate logistic regression analysis showed that preoperative International Cartilage Repair Society (ICRS) grade was the only factor affecting cartilage repair. Conclusions: CWHTO improved clinical outcomes and cartilage status as much as OWHTO. Although the effects of cartilage repair on clinical outcomes are unknown, HTO is an effective treatment option even for severe medial OA of the knee.

The Effect of Reflexology on Labor Pain and Length Among Primiparous Women: A Randomized Controlled Trial

2018 ◽  
Vol 7 ◽  
Author(s):  
Azita Kamjoo
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Active Phase ◽  
Labor Pain ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Group Data ◽  
Significant Difference ◽  
Labor Length ◽  
Primiparous Women

Background: Pain control is considered as the key issue in modern midwifery. Along with medical painkillers, reflexology is viewed as a non-medical and noninvasive method. Hence, we aimed to investigate the effect of reflexology on the intensity of pain and length of labor. Materials and Methods: In this clinical trial, participants included 240 Iranian primiparous women with term and singleton pregnancy. Having a 3-4 cm cervical dilatation once they visited the hospital. Through a convenient sampling method, they were selected and then randomly divided into two groups. In the intervention group, reflexology was performed, and the intensity of pain during the active phase of labor along with the length of labor in the active phase was measured by visual analog scale (VAS) and compared with the control group. Data were analyzed using descriptive statistics, t-test, and Mann-Whitney U-test. Result: Data analysis showed a statistically significant difference between the intensity of pain in the 5-7 and 8-10 cm dilatation in the two groups (P=0.01). Moreover, the labor length in the active phase was found to be significantly shorter in the intervention group (P<0.001). Conclusion: It appears that reflexology can lead to a reduction in the pain and length of labor. Therefore, through instructing this technique, a goal of midwifery, which is reducing labor pain and its length can be achieved. Keywords: Reflexology, Labor Pain, Labor Length, Primiparous Women

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