Mutual exclusivity of neck of femur and pubic ramus fractures in the elderly. Is it a fact?

2013 ◽  
Vol 24 (6) ◽  
pp. 651-652
Author(s):  
Harinder Gakhar ◽  
Salim Punjabi ◽  
Naveed Ahmed ◽  
Ajay Sharma
Keyword(s):  
The Elderly ◽  
Mutual Exclusivity ◽  
Neck Of Femur ◽  
Pubic Ramus

scholarly journals Preoperative and Postoperative Oxygen Saturation in the Elderly following Spinal or General Anaesthesia—An Audit of Current Practice

1994 ◽  
Vol 22 (2) ◽  
pp. 150-154 ◽  
Author(s):  
A. G. Brown ◽  
A. R. Visram ◽  
R. D. M. Jones ◽  
M. G. Irwin ◽  
J. Bacon-Shone
Keyword(s):  
Elderly Patients ◽  
Oxygen Saturation ◽  
Signal Amplitude ◽  
The Elderly ◽  
Analysis Data ◽  
General Anaesthetic ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur ◽  
Screw Insertion ◽  
Hip Screw

We have compared the incidence of preoperative and postoperative oxygen desaturation in 20 elderly patients undergoing dynamic hip screw insertion for fractured neck of femur, allocated randomly to two groups to receive subarachnoid anaesthesia (SA, n = 10) or a general anaesthetic (GA, n = 10). Oximetry data were recorded during the preoperative night and the first 48 hours after surgery using Satmaster.™ Data associated with zero amplitude signal were automatically invalidated by the software and decreases in SpO2 which were preceded by contemporaneous changes in signal amplitude which conformed to a previously described template were assumed to be artefactual and were discarded from final data analysis. Data demonstrated a wide interpatient variability. However, those patients who desaturated preoperatively continued to do so in the postoperative period. The differences between the preoperative and postoperative oximetry profiles were examined for each patient and demonstrated a significantly longer time spent with SpO2 <90% in the GA group compared with the SA group, in all the recorded time periods, except on the day of surgery. The SA group showed an improvement in oxygen saturation postoperatively when compared to the preoperative night, spending less time with an SpO2 <85%. We conclude that the subarachnoid anaesthetic technique was associated with a lower incidence of postoperative oximetry desaturation when compared with general anaesthetic for these elderly patients undergoing repair of fractured neck of femur.

scholarly journals Techniques for the Management of Failed Surgery for Fractures of the Neck of Femur

2017 ◽  
Vol 11 (1) ◽  
pp. 1223-1229
Author(s):  
Philip M Stott ◽  
Sunny Parikh
Keyword(s):  
Hip Fracture ◽  
High Volume ◽  
The Elderly ◽  
Normal Function ◽  
Optimal Management ◽  
Tips And Tricks ◽  
Neck Of Femur ◽  
Management Of Complications ◽  
Failed Surgery ◽  
Surgical Treatments

Background: The majority of modern surgical treatments for managing hip fracture in the elderly are successful and result in a very low rate of revision surgery. Subsequent operations are however occasionally necessary. Optimal management of complications such as infection, dislocation or failed fixation is critical in ensuring that this frail patient group is able to survive their treatment and return to near normal function. Methods: This paper is a discussion of techniques, tips and tricks from a high volume hip fracture unit Conclusion: This article is a technique-based guide to approaching the surgical management of failed hip fracture treatment and includes sections on revising both failed fixation and failed arthroplasty.

scholarly journals What characteristics indicate concomitant posterior pelvic injury in pubic ramus fractures in the elderly?

2020 ◽  
Vol 106 (5) ◽  
pp. 849-853
Author(s):  
Eic Ju Lim ◽  
Jung Jae Kim ◽  
Ji Wan Kim ◽  
Keong-Hwan Kim
Keyword(s):  
The Elderly ◽  
Pelvic Injury ◽  
Pubic Ramus

scholarly journals Risk factors for onset of delirium after neck of femur fracture surgery: a prospective observational study

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 27 ◽  
Author(s):  
Muaaz Tahir ◽  
Shahbaz S Malik ◽  
Usman Ahmed ◽  
Jakub Kozdryk ◽  
Syeda Huma Naqvi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Binary Logistic Regression ◽  
The Elderly ◽  
Cognitive Status ◽  
Adverse Outcomes ◽  
Electrolyte Imbalance ◽  
Chronic Obstructive ◽  
Neck Of Femur ◽  
Obstructive Pulmonary Disease

Background: Delirium is a common complication after surgery in the elderly that leads to increased length of stay and other adverse outcomes. The aim of this study was to better understand the exact causes of post-operative delirium in patients undergoing surgery for neck of femur (NOF) fractures. Methods: We performed a prospective cohort study of 381 consecutive patients undergoing surgery for NOF fractures at a single institution. Baseline cognitive status and risk factors were recorded on admission. Post-operative cognitive status was assessed at regular intervals until discharge. Binary logistic regression was performed to identify independent predictors of delirium. Results: Patients who developed post-operative delirium (n = 70) were significantly older (average age 83 vs. 78, p = 0.019) and more likely to be female (79% vs. 67%, p = 0.062) than non-affected patients. The presence of delirium was associated with increased length of stay (13 vs. 10 days, p = 0.001) and 1-year mortality (25.7% vs. 15% p = 0.03). Independent predictors of delirium included age ≥65 years (Odds Ratio = 5.8), presence of anaemia (OR = 2.9), hypoxia (OR = 2.86), cardiac disease (OR = 2.8), Chronic Obstructive Pulmonary Disease (OR = 2.5), new onset electrolyte imbalance (OR = 2.2) and renal failure (OR = 1.9). Conclusion: Overall analysis demonstrated an increased incidence of delirium in older females with greater comorbid conditions. It was also found to be associated with increased morbidity and mortality. We recommend clinicians put greater effort into recognising risk factors of delirium and diagnosing it in a timely manner to mitigate its effects.

scholarly journals 58 Epidemiology of Falls and HIP Fractures among the Elderly Community Dwellers in Malaysia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Raymond Yeak ◽  
Yee Yee Yap ◽  
Nizlan M Nasir
Keyword(s):  
Nursing Homes ◽  
Hip Fractures ◽  
Asian Population ◽  
The Elderly ◽  
Subtrochanteric Fracture ◽  
Morbidity And Mortality ◽  
Prevention Measures ◽  
Neck Of Femur ◽  
Tertiary Centre ◽  
Type Of Fracture

Abstract Introduction Elderly community dweller has a high risk of falls. It has a high incidence of morbidity and mortality if it involves hip fractures. Our aim is to report the incidence of falls presenting with hip fractures to a Malaysian tertiary centre. Method We have collected data from a Malaysian tertiary centre. The incidence of falls involving elderly patients aged 65 and above from January 2018 till December 2018 was examined. The falls were divided based on the time of fall, place and the type of fracture. Time of fall was divided into day (0800 to 1559), evening (1600 to 2359), night (0000 to 0759). The place was either outdoor or indoor. Results There were 114 falls that involved hip fractures recorded over the past 12 months. There were 85 female cases versus 29 male cases. The average age was 77.3 years. There was a higher incidence in the Chinese (n=59) followed by the Malay (n=40) and Indian (n=15). There were no cases of nursing homes falls that involved hip fractures. Most of the falls with hip fractures occurred indoor with only 11 cases that occurred outdoor. The falls tend to occur in the day (n=65) followed by evening (n=31) and night (n=18). October recorded the highest number of falls with 14 cases followed by April (n=13), and December (n=12). The type of fracture in descending order were intertrochanteric fracture (n=61), neck of femur fracture (n=47), subtrochanteric fracture (n=4) and acetabular fracture (n=2). Conclusion Asians generally care for their aging parents in the family home. Although falls were reported to be higher in nursing homes, this differs in the Asian population. Therefore, fall prevention measures should be implemented at home as falls is a significant cause of morbidity and mortality in the elderly especially if it involves hip fractures.

Neck of femur fractures in the elderly: Does every hour to surgery count?

Injury ◽  
2017 ◽  
Vol 48 (6) ◽  
pp. 1155-1158 ◽  
Author(s):  
Natasha Morrissey ◽  
Efthymios Iliopoulos ◽  
Ahmad Wais Osmani ◽  
Kevin Newman
Keyword(s):  
The Elderly ◽  
Neck Of Femur ◽  
Femur Fractures

RISK FACTORS FOR FRACTURED NECK OF FEMUR IN THE ELDERLY

1982 ◽  
Vol 11 (3) ◽  
pp. 160-168 ◽  
Author(s):  
R. WOOTTON ◽  
ELAINE BRYSON ◽  
U. ELSASSER ◽  
HEATHER FREEMAN ◽  
J. R. GREEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
The Elderly ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur

scholarly journals Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

2020 ◽  
Vol 6 (2) ◽  
pp. 333
Author(s):  
Harpreet Singh ◽  
Tej S. Rudani ◽  
Malay P. Gandhi ◽  
Aliasgar J. Rampurwala
Keyword(s):  
Excellent Result ◽  
The Elderly ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Neck Of Femur Fracture ◽  
Uncemented Group

<p class="abstract"><strong>Background:</strong> The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.</p><p><strong>Conclusions:</strong> Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery &amp; complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study. </p>

scholarly journals Introducing the principles of Enhanced Recovery to a fractured neck of femur pathway 5 years results and experience

2020 ◽  
Author(s):  
Thomas Wainwright ◽  
Tikki Immins ◽  
Robert Middleton
Keyword(s):  
Relative Risk ◽  
Qualitative Data ◽  
Enhanced Recovery ◽  
Admission Rate ◽  
The Elderly ◽  
Outcome Data ◽  
Case Mix ◽  
Key Factors ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur

Introduction There is great potential for the principles of Enhanced Recovery to be successfully applied to fractured neck of femur (FNOF) pathways and help to improve clinical outcomes. Aim To present the 5-year results and experience from Poole Hospital of applying the principles of Enhanced Recovery to FNOF patients. Method A mixed-methods sequential explanatory design (QUAN emphasised) that consists of quantitative followed by qualitative data collected to evaluate the project. Quantitative outcome data were extracted from Hospital Episode Statistics for 2008/09 to 2013/14 and analysed using a relative risk methodology. Relative Risk is the ratio of the observed number of outcomes to the expected number of outcomes and is case-mix adjusted. The NHS England average is calculated and 95% confidence intervals are applied to determine statistical difference from unit performance to the equivalent case-mix. Qualitative data were collected via staff interviews. Results A mean length of stay (LOS) of 12.3 days, a mortality rate of 5.7%, a 28-day re-admission rate of 10.2%, and a discharge home rate of 55% achieved in the last year of the project are lower than expected for hospital case-mix Staff interviews highlighted that key factors for success were: 1.Collaborative practice across all teams 2.Input from the Department of Medicine for the Elderly 3.Changing the pre-operative mindset whereby instead of having to prove patients are fit for surgery, they are assessed as fit for surgery unless proven otherwise. Conclusions Enhanced Recovery can be successfully applied to FNOF patients in order to improve patient outcomes. However, implementation may be more challenging and take longer than for elective orthopaedic procedures.

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