scholarly journals Lateral and Posterior Approaches in Hemiarthroplasty

2018 ◽  
Vol 107 (3) ◽  
pp. 260-268 ◽  
Author(s):  
M. T. Hongisto ◽  
M. S. Nuotio ◽  
T. Luukkaala ◽  
O. Väistö ◽  
H. K. Pihlajamäki
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Confidence Interval ◽  
Living Arrangements ◽  
Odds Ratio ◽  
Posterior Approach ◽  
Hip Dislocation ◽  
Lateral Approach ◽  
Mobility Aids ◽  
Neck Fracture

Purpose: Hemiarthroplasty is a common treatment for patient with a fragility displaced femoral neck fracture. We compared lateral and posterior approaches with respect to need for mobility aids, mobility level, living arrangements, pain, hip dislocation, and survival 12 months after hip fracture. Methods: A total of 393 fragility femoral neck fracture patients aged 65 years or more who underwent hemiarthroplasty were observed for 12 months. Patient information was collected on admission, during hospitalization, and by telephone interview 1 year after the hip fracture. A total of 269 patients were included in the final analysis. Results: At 1 year after hip fracture, more patients undergoing hemiarthroplasty with the posterior approach (22%) survived without mobility aids compared to those with the lateral approach (12%; p = 0.026). Multivariate logistic regression analysis revealed that the need for mobility aids 1 year after hip fracture was significantly predicted by the use of mobility aids before the fracture (odds ratio = 13.46, 95% confidence interval = 4.29–42.25), age ≥85 years (odds ratio = 3.85, 95% confidence interval = 1.09–13.44), male sex (odds ratio = 3.59, 95% confidence interval = 1.05–12.22), and lateral approach (odds ratio 2.73, 95% confidence interval 1.15–6.50). The posterior approach resulted in four (3.4%) dislocated hips, compared with none by the lateral approach. Survival, mobility level, pain in the operated hip, and living arrangements 1 year postoperatively were not significantly different between groups. Conclusion: Hemiarthroplasty using a lateral approach predisposed to the need for ambulatory aids 1 year after hip fracture. The posterior approach, however, predisposed to hip dislocation. Patient selection must be considered when deciding the appropriate surgical approach.

scholarly journals Hip dislocation following the treatment of femoral neck fracture: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 248-251
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Borislav Dulic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Young Patients ◽  
Hip Dislocation ◽  
Full Weight Bearing ◽  
Limited Range Of Motion ◽  
Femoral Head Osteonecrosis ◽  
Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

scholarly journals PMS40 270-DAYMORTALITY AND ITS PREDICTORS IN WOMEN WITH CONTRALATERAL HIP FRACTURE AFTER FEMORAL NECK FRACTURE

2019 ◽  
Vol 22 ◽  
pp. S701
Author(s):  
K. Juhász ◽  
I. Boncz ◽  
B. Molics ◽  
B. Gratz ◽  
A. Sebestyén
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Neck Fracture

scholarly journals Az ellenoldali csípőtáji törésig eltelt időt befolyásoló prognosztikai tényezők vizsgálata

2018 ◽  
Vol 159 (38) ◽  
pp. 1543-1547
Author(s):  
Krisztina Juhász ◽  
Imre Boncz ◽  
Péter Kanizsai ◽  
Andor Sebestyén
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Hip Fractures ◽  
Age Groups ◽  
Significant Difference ◽  
Neck Fracture ◽  
The Impact

Abstract: Introduction: Although several national studies reported on the risk factors for contralateral hip fracture, there are no data about the prognostic factors of the time until contralateral hip fractures. Aim: The aim of the study was to analyse the impact of different prognostic factors on the time until the development of contralateral fracture and to determine the incidence of contralateral hip fractures after femoral neck fractures. Method: Patients aged 60 years and over with contralateral hip fracture between 01 Jan 2000 and 31 Dec 2008 were identified among those who suffered their femoral neck fracture in Hungary in 2000. Risk factors as age, sex, comorbidities, type of fracture and surgery, place of living and hospitals providing treatment for primary fracture were analysed by one way ANOVA focusing on the time until the development of contralateral hip fracture. Results: 312 patients met the inclusion criteria. The incidence of contralateral hip fracture after femoral neck fracture ranged between 1.5% and 2.1%, the cumulative incidence was 8.24%. The mean time until the development of contralateral hip fracture was 1159.8 days. The incidence of contralateral hip fracture showed no significant deviation. Significantly shorter time (p = 0.010) was detected until the contralateral hip fracture in older patients with femoral neck fracture. Conclusions: The yearly incidence of contralateral hip fracture showed no significant difference by patients with femoral neck fracture over 60 years. The shorter time until the contralateral hip fracture by the older age groups highlights the need of elaboration of prevention strategies. Orv Hetil. 2018; 159(38): 1543–1547.

Surgical treatment of a vertebral fracture associated with a haematogenous osteomyelitis in a dog

2007 ◽  
Vol 20 (03) ◽  
pp. 227-230 ◽  
Author(s):  
P. Moissonnier ◽  
J. Cabassu
Keyword(s):  
Surgical Treatment ◽  
Vertebral Fracture ◽  
Femoral Neck ◽  
Clinical Signs ◽  
Pathologic Fracture ◽  
Lateral Approach ◽  
Direct Access ◽  
Computed Tomographic ◽  
Neck Fracture ◽  
Haematogenous Osteomyelitis

SummaryA seven-month-old Rottweiler was referred for a diagnosed femoral neck fracture and a suspected vertebral fracture. The simplified neurological examination revealed an acute paraplegia. A discospondyilitis associated with a pathologic fracture of Th11 and a spinal compression, and a haematogenous epiphysitis of the femoral neck were diagnosed based on radiographic and computed tomographic examinations. The vertebral fracture was stabilised using screws and polymethylmetacrylate with gentamycin by a lateral intercostal approach. The dog was able to walk seven days later. A femoral head and neck ostectomy was performed two weeks later. Staphylococcus intermedius was isolated from both sites, which confirmed the diagnosis. The dog was treated with cephalexin (30 mg/kg/d) for six weeks. A telephone interview with owners indicated that no more clinical signs were present four months after the second surgery. Discospondylitis associated with haematogenous osteomyelitis has only been reported in two cases. Paraplegia is an unusual clinical presentation for discospondylitis. The lateral approach (which allowed a direct access to the infected site) and the technique (screws associated with antibiotic-impregnated cement) are unique for surgical treatment of discospondylitis. Although applying cement to an infected area may pose a risk, antibiotic-loaded cement is successfully used in the treatment of chronic osteomyelitis in humans.

scholarly journals Using Patient-Reported Outcomes to Predict Revision Arthroplasty Following Femoral Neck Fracture: Enhancing the Value of Clinical Registries through Data Linkage

2019 ◽  
Vol 16 (8) ◽  
pp. 1325 ◽  
Author(s):  
Christina L Ekegren ◽  
Richard de Steiger ◽  
Elton R Edwards ◽  
Richard S Page ◽  
Raphael Hau ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Data Linkage ◽  
Multivariable Analysis ◽  
Revision Arthroplasty ◽  
Factors Associated ◽  
Clinical Registries ◽  
Patient Reported ◽  
Neck Fracture

The aim of this study was to determine the association between patient-reported outcome measures (PROMs) six months following femoral neck fracture after a low fall and future arthroplasty, and the factors associated with this. Six-month post-fracture PROMs were collected from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) for patients aged >55 years who were admitted for a femoral neck fracture after a low fall between March 2007 and June 2015. These cases were linked with those registered by Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) up to October 2016. Multivariable analysis was performed using a Cox proportional hazards model to determine factors associated with future arthroplasty, including six-month PROMs. Of the 7077 hip fracture patients registered by VOTOR during the study period, 2325 met the inclusion criteria. Internal fixation being used for the initial hip fracture surgery, being younger and having no pre-injury disability were all independently associated with future revision or conversion to arthroplasty. Out of all PROMs, reporting pain and discomfort six months post-fracture was associated with a 9.5-fold increase in the risk of future arthroplasty (95% CI: 3.81, 23.67). The value of clinical registries can be enhanced via data linkage, in this case by using PROMs to predict arthroplasty following femoral neck fracture.

scholarly journals Antithrombotics in Patients With a Femoral Neck Fracture: Evaluating Daily Practice in an Observational Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932110377
Author(s):  
Veronique A. J. I. M. van Rijckevorsel ◽  
Gert R. Roukema ◽  
Taco M. A. L. Klem ◽  
Tjallingius M. Kuijper ◽  
Louis de Jong
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Observational Cohort Study ◽  
Total N ◽  
Hip Hemiarthroplasty ◽  
Time To Surgery ◽  
Neck Fracture ◽  
Observational Cohort

Introduction Geriatric hip fracture patients are characterized by frailty due to multiple comorbidities, such as cardiovascular disease, in which the use of antithrombotics is frequent. The aim of this study is to assess the effect of antithrombotics on perioperative care and patient outcomes after hip hemiarthroplasty following current guidelines. Materials and Methods This observational cohort study included all consecutively admitted patients with a femoral neck fracture requiring hip hemiarthroplasty between January 1st 2010, and May 16th 2016, in two level II trauma teaching hospitals. Patients with multiple trauma injuries were excluded. Results In total, n = 907 patients (68% female (n = 615), median age 84 years) were included of which n = 142 used a vitamin K antagonist (VKA) and n = 213 used antiplatelet (AP) therapy. Both were associated with more packed cell supplementation (.4 ± 1.1 units and .3 ± .8 units vs .2 ± .6 units, P < .001 and P = .03, respectively). VKA was associated with more hematomas compared no antithrombotics (23% vs 11%, P = .001). VKA had a longer time to surgery compared to no antithrombotics and AP (24 hours vs 19 and 20 hours, P < .001 and P < .001, respectively) and longer admission duration (9 days vs 7 days P < .001. There were no differences in 30 day mortality nor in 1-year mortality rates. Discussion All modifiable causes for deep SSI, such as hematomas, should be prevented in acute hip fracture surgery. Since antithrombotics are associated with hematomas, an optimal handling in perioperative setting is necessary. Conclusion VKA was associated with longer time to surgery, more hematomas, and longer admission duration. VKA and AP were associated with more packed cell supplementation.

scholarly journals Organisational Determinants and Consequences of Diagnostic Discrepancy in Emergency Departments: A National Study of Consecutive Episodes Between 2008-2016

2020 ◽  
Author(s):  
Line Stjernholm Tipsmark ◽  
Børge Obel ◽  
Tommy Andersson ◽  
Rikke Søgaard
Keyword(s):  
Emergency Department ◽  
Hip Fracture ◽  
Observational Study ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Healthcare Sector ◽  
National Study ◽  
Common Phenomenon ◽  
Mixed Effect ◽  
Mixed Effect Models

Abstract Background Diagnostic discrepancy (DD) is a common phenomenon in healthcare, but little is known about its organisational determinants and consequences. Thus, the aim of the study was to evaluate this among selected emergency department (ED) patients. Method We conducted an observational study including all consecutive ED patients (hip fracture or erysipelas) in the Danish healthcare sector admitted between 2008 and 2016. DD was defined as a discrepancy between discharge and admission diagnoses. Episode and department statistics were retrieved from Danish registers. We conducted a survey among all Danish EDs (m=21) to inform organisational determinants. To estimate the results while adjusting for episode- and department-level heterogeneity, we used mixed effect models of ED organisational determinants and 30-day readmission, 30-day mortality and episode costs (2018-DKK) of DDs. ResultsDD was observed in 2,308 (3.3%) of 69,928 hip fracture episodes and 3,206 (8.5%) of 37,558 erysipelas episodes. The main organisational determinant of DD was senior physicians being employed at the ED (hip fracture: odds ratio (OR) 2.74, 95% confidence interval (CI) 2.15-3.51; erysipelas: OR 3.29, 95% CI 2.65-4.07). However, 24-hour presence of senior physicians (hip fracture) and availability of external senior physicians (both groups) were negatively associated with DD. DD was associated with increased 30-day readmission (hip fracture, mean 9.45% vs 13.76%, OR 1.46, 95% CI 1.28-1.66, p<0.001) and episode costs (hip fracture, 61,681 DKK vs 109,860 DKK, log cost 0.58, 95% CI 0.53-0.63, p<0.001; erysipelas, mean 20,818 DKK vs 56,329 DKK, log cost 0.97, 95% CI 0.92-1.02, p<0.001) compared with episodes without DD. Conclusion DD affects outcomes, and particular organisational characteristics seem to be associated with DD. Yet, the complexity of organisations and settings warrant further studies into these associations.

scholarly journals “Acute Primary Total Hip Arthroplasty for Combined Posterior Acetabulum Fracture with Ipsilateral Associated Posteriorly Dislocated Femoral Head with Femoral Neck Fracture. Using of Femoral Head as an Autograft Would be an Advantage”

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Babaji Thorat ◽  
Avtar Singh ◽  
Mohammad Arshad ◽  
Sharad Salokhe ◽  
Ravi Mavani
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Hip Dislocation ◽  
High Energy ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Neck Fracture ◽  
Posterior Hip Dislocation

Introduction: Traumatic posterior hip dislocation with comminuted fracture of the ipsilateral acetabulum and femoral neck is a rare fracture pattern. These injuries are associated with high energy trauma and pose challenges during management. Controversy exists between hip preservation and replacement surgeries in middle-age patients. Open reduction and internal fixation (ORIF) have a high risk of non-union, avascular necrosis, and post-traumatic osteoarthritis of hip requiring total hip arthroplasty hip replacement (THA) as a secondary procedure later. Case Report: A 56-year-old male presented with posterior hip dislocation and comminuted fracture of ipsilateral wall and column of the acetabulum, and femoral neck following a high energy trauma. He was managed by acetabular reconstruction using femoral head structural autograft combined with acute primary uncemented THA. At 2-year follow-up, the patient had good functional outcome with a satisfactory range of motion without any difficulty in weight-bearing and doing his daily activities. Conclusion: Although uncommon, acetabular reconstruction using femoral head structural autograft and acute primary uncemented THA is a viable alternative treatment option compared to ORIF in middle-age patients with fracture of ipsilateral neck and acetabulum. This facilitates post-operative rehabilitation and avoids further operations for possible developing AVN or secondary arthritis. Keywords: Hip dislocation, acetabulum fracture, femur neck fracture, acute total hip arthroplasty, acetabular reconstruction, femoral head structural autograft.

Sign in / Sign up

Export Citation Format

Share Document