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.

Plasma Aspirin Esterase Activity in Elderly Patients undergoing Elective Hip Replacement and with Fractured Neck of Femur

1994 ◽  
Vol 23 (4) ◽  
pp. 338-341 ◽  
Author(s):  
M. SINEAD O'MAHONEY ◽  
GRAEME GEORGE ◽  
HELEN WESTLAKE ◽  
KEN WOODHOUSE
Keyword(s):  
Elderly Patients ◽  
Hip Replacement ◽  
Esterase Activity ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur

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 Intracortical Screw Insertion Plus Limited Open Reduction in Treating Type 31A3 Irreducible Intertrochanteric Fractures in the Elderly

2021 ◽  
Author(s):  
Xiao-wen Huang ◽  
Gu-qi Hong ◽  
Qiang Zuo ◽  
Chen Qun
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Open Reduction ◽  
Operation Time ◽  
The Elderly ◽  
Fracture Reduction ◽  
Intertrochanteric Fractures ◽  
X Rays ◽  
Intraoperative Blood Loss ◽  
Screw Insertion

Abstract Objective: To discuss the clinical efficacy of intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly. Methods: A retrospective analysis was performed for 23 elderly patients with type 31A3 irreducible intertrochanteric fractures (12 males and 11 females, aged 65-89 years old, with an average of 75.6±5.1 years old) who received treatment at the orthopedics department of our hospital from September 2017 to August 2019. After type 31A3 irreducible intertrochanteric fractures were confirmed by intraoperative C-arm, all of these cases received intracortical screw insertion plus limited open reduction in the broken end with intramedullary screw internal fixation. The basic information of surgery, reduction effects, and FRS scores of the hip joint were assessed. Results: All patients were followed up for an average of 13.8 months. The operation time was 53.8±13.6min (40-95min). The intraoperative blood loss was 218.5±28.6ml (170-320ml). The average number of intraoperative X-rays was 22.8±4.6 (18-33). The average time to fracture union was 4.8±0.7 months. The reduction effect was assessed using Kim's fracture reduction evaluation. 20 cases achieved grade I fracture reduction and 3 cases grade II fracture reduction. All of them achieved excellent or good fracture reduction. Upon the last follow-up, the FRS score was 83.6±9.8, which was not significantly different from the FRS score (84.8±10.7) before the fracture (t= 0.397, P= 0.694). Conclusion: With careful preoperative preparation, intracortical screw insertion plus limited open reduction could achieve high-quality fracture reduction and fixation in elderly patients with type 31A3 irreducible intertrochanteric fractures. Good clinical outcomes were achieved without increasing operation time and intraoperative blood loss.

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.

Short-term (2 years) results of primary total hip replacement in 40 mobile elderly patients with fractured neck of femur

2017 ◽  
Vol 52 (3) ◽  
pp. 175
Author(s):  
SherifA Khaled ◽  
MohamedS Abd El-Maksoud Mohamed Ismail ◽  
Ashraf El-Nahal ◽  
Ibrahim El-Geady
Keyword(s):  
Elderly Patients ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Short Term ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur ◽  
Total Hip
Sign in / Sign up

Export Citation Format

Share Document