scholarly journals Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

2021 ◽  
Vol 9 (32) ◽  
pp. 9752-9761
Author(s):  
Xiao-Wen Huang ◽  
Gu-Qi Hong ◽  
Qiang Zuo ◽  
Qun Chen
Keyword(s):  
Open Reduction ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Screw Insertion

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 The Correlation Between Timing of Surgery and the Need for RBC Transfusions in the Geriatric Intertrochanteric Fracture Population

2021 ◽  
Vol 12 ◽  
pp. 215145932199861
Author(s):  
Yun-fa Yang ◽  
Jian-wen Huang ◽  
Xiao-sheng Gao ◽  
Zai-li Liu ◽  
Jian-wei Wang ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
The Elderly ◽  
Timing Of Surgery ◽  
Intertrochanteric Fractures ◽  
The Third ◽  
Transfusion Requirements ◽  
Surgical Fixation ◽  
Fracture Population ◽  
The Relationship ◽  
Rbc Transfusion

Objective: To identify whether the timing of surgery affects red blood cell (RBC) transfusion requirements in the elderly with intertrochanteric fractures. Methods: We retrospectively studied all patients undergoing surgical fixation of their intertrochanteric fractures in our hospital between January 2009 and December 2018 and analyzed the relationship between the timing of surgery and RBC transfusion. Results: A total of 679 patients were included in this study. The need for RBC transfusion was lower in the patients who underwent surgery within 12 h after admission (timing of surgery <12 h, <12 h group) than those who underwent surgery over 12 h after admission (timing of surgery >12 h, >12 h group) (P = 0.046); lower in the the patients who underwent surgery within 24 h after admission (timing of surgery <24 h, <24 h group) than in those who underwent surgery over 24 h after admission (timing of surgery >24 h, >24 h group) (P = 0.008), and lower in the <24 h group compared to the patients who underwent surgery within 48 h after admission (timing of surgery <48 h, <48 h group) (P = 0.035). Moreover, the need for RBC transfusion was lower in the <24 h group (in the first 24 h from admission to surgery) than in the 24-48 h group (in the second 24 h from admission to surgery) (P = 0.016), and also lower in the <24 h group compared to the 48-72 h group (in the third 24 h from admission to surgery) (P = 0.047). However, there were no differences between the <12 h group and 12-24 h group, between the <12 h group and <24 h group, and between the 12-24 h group and <24 h group, respectively. Conclusion: Timing of surgery within 24 h contributes to the reduction of RBC transfusion in the elderly with intertrochanteric fractures.

Complex fractures of the distal humerus in the elderly: primary total elbow arthroplasty or open reduction and internal fixation? Mid-term follow-up

2021 ◽  
Author(s):  
Yaiza Lopiz ◽  
Daniel Garríguez-Pérez ◽  
Carlos García-Fernández ◽  
Laura del Baño ◽  
María Galán-Olleros ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
The Elderly ◽  
Distal Humerus ◽  
Total Elbow Arthroplasty ◽  
Elbow Arthroplasty ◽  
Complex Fractures

Treatment of Distal Radius Fractures in Women Older than 80 Years: A Preliminary Report of Functional and Radiographic Outcomes after Open Reduction and Internal Fixation

2021 ◽  
Author(s):  
Lili E. Schindelar ◽  
Richard M. McEntee ◽  
Robert E. Gallivan ◽  
Brian Katt ◽  
Pedro K. Beredjiklian
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Functional Outcomes ◽  
Open Reduction ◽  
The Elderly ◽  
Distal Radius Fractures ◽  
Implant Design ◽  
Complication Rates ◽  
Radius Fractures ◽  
Hardware Failures

Abstract Background Distal radius fractures are one of the most common fractures seen in the elderly. The management of distal radius fractures in the elderly, especially patients older than 80 years, has not been well defined. The purpose of this study was to evaluate operative treatment of distal radius fractures in patients older than 80 years to determine functional outcomes and complication rates. Materials and Methods A retrospective review was performed to identify patients 80 years or older who were treated for a distal radius fracture with open reduction and internal fixation (ORIF). Medical records were reviewed for demographics, medical history, functional outcomes including quick Disabilities of the Arm, Shoulder, and Hand (qDASH), radiographs, and postoperative complications. Results There were 40 patients included for review. Average age was 84 years. The preoperative qDASH score was 69. At 6 months follow-up, the postoperative qDASH score was 13 (p < 0.001). There were five (12.5%) complications reported postoperatively. All fractures healed with adequate radiographic alignment and there were no hardware failures. Conclusion Distal radius fractures in patients older than 80 years treated with ORIF have good functional outcomes and low complication rates. Increased functionality and independence of the elderly, as well as updated implant design can lead to the effective surgical management of these patients. When indicated from a clinical perspective, operative fixation of distal radius fractures should be considered in patients older than 80 years.

The Role of Lateral Buttress in Treatment of Jensen type 4 Intertrochanteric Fractures of the Femur using Dynamic Compression Hip Screw in the Elderly

2005 ◽  
Vol 40 (7) ◽  
pp. 935 ◽  
Author(s):  
Yong Sik Kim ◽  
Soon Yong Kwon ◽  
Suk Ku Han ◽  
Woo Hyuk Choi ◽  
Nam Yong Choi
Keyword(s):  
Dynamic Compression ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Hip Screw ◽  
Fractures Of The Femur

scholarly journals Admission deep venous thrombosis of lower extremity after intertrochanteric fracture in the elderly: a retrospective cohort study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinzeng Zuo ◽  
Yongcheng Hu
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Lower Extremities ◽  
The Elderly ◽  
Intertrochanteric Fractures ◽  
Targeted Interventions ◽  
Laboratory Test Results

Abstract Objective The purpose of this study was to investigate the incidence, location, and related factors of deep venous thrombosis (DVT) of the bilateral lower extremities after intertrochanteric fractures in the elderly. Methods Retrospective analysis was performed on the elderly patients with intertrochanteric fracture who were admitted from January 2017 to December 2019. At admission, patients receive routine ultrasound Doppler scanning of bilateral lower extremities to detect DVT; those with DVT were assigned to the case group and those without DVT to the control group. Patient data on demographics, comorbidities, injury-related data, and laboratory test results at admission were extracted. Logistic regression analyses were conducted to identify the independent risk factors associated with DVT. Results Five hundred seventy-eight patients were included, among whom 116 (20.1%) had DVT. Among those with DV, 70.7% (82/116) had DVT of the distal type, 24 (29.6%) had DVT of the proximal type, and 10 (10.4%) had mixed DVT. In 76.7% (89/116) of patients, DVT occurred in the fractured extremity, 9.5% (11/116) in the bilateral and 13.8% (16/116) in the non-fractured extremity. Multivariate analyses identified obesity, delay to admission, increased D-dimer level (> 1.44 mg/L) and reduced albumin (< 31.7 g/L) as independent factors. Conclusions Admission incidence of DVT was high in elderly patients with intertrochanteric fractures, especially the proximal DVT. Identification of associated risk factors is useful for individualized assessment risk of DVT and early targeted interventions.

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.

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