X-Bolt unforeseen placement complication: case report

With the introduction of the World Hip Trauma Evaluation Four clinical trial, fixation of pertrochanteric neck of femur fractures is becoming a hot topic. In this trial, the novel X-Bolt expanding bolt implant is being compared with the current gold standard of a sliding hip screw. We present a previously undescribed complication when inserting the bolt into the femoral head, where the expandable wings penetrate the femoral neck due to misplacement of the bone crusher or the X-Bolt prosthesis. This unforeseen complication required the introduction of several additional corrective intraoperative steps.

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A case report of Progressive subluxation leading to an anterior dislocation of the hip following sliding hip screw fixation for pertrochanteric Extracapsular 4 part fracture neck of femur

Clinical Case Reports ◽

10.1002/ccr3.291 ◽

2015 ◽

Vol 3 (7) ◽

pp. 542-547 ◽

Cited By ~ 1

Author(s):

Jaydeep Shah ◽

Ben A. Marson

Keyword(s):

Case Report ◽

Screw Fixation ◽

Anterior Dislocation ◽

Sliding Hip Screw ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Hip Screw ◽

Dislocation Of The Hip

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Impact of COVID-19 pandemic on hip fractures: the central London experience COVID-related urgent geriatric hip trauma (COUGH) study COVERT ( COVid Emergency-Related Trauma and orthopaedics) collaborative

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02687-z ◽

2021 ◽

Author(s):

Chang Park ◽

Kapil Sugand ◽

Arash Aframian ◽

Catrin Morgan ◽

Nadia Pakroo ◽

...

Keyword(s):

Best Practice ◽

Neck Of Femur ◽

Health Crisis ◽

Femur Fractures ◽

Time Period ◽

Vulnerable Patients ◽

Significant Difference ◽

Usual Residence ◽

Hip Trauma ◽

The Impact

Abstract Introduction COVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals. Materials and methods A multi-center, longitudinal, retrospective, observational study of NOFF patients was performed for the first ‘golden’ month following the lockdown measures introduced in mid-March 2020. This was compared to the same time period in 2019. Results A total of 78 cases were observed. NOFFs accounted for 11% more of all acute referrals during the COVID era. There were fewer overall breaches in KPIs in time to theatre in 2020 and also for those awaiting an orthogeriatric review. Time to discharge from the trust during the pandemic was improved by 54% (p < 0.00001) but patients were 51% less likely to return to their usual residence (p = 0.007). The odds ratio was significantly higher for consultant surgeon-led operations and consultant orthogeriatric-led review in the post-COVID era. There was no significant difference in using aerosol-generating anaesthetic procedures or immortality rates between both years. Conclusion The impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.

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Optimization of the CDC Protocol of Molecular Diagnosis of COVID-19 for Timely Diagnosis

Diagnostics ◽

10.3390/diagnostics10050333 ◽

2020 ◽

Vol 10 (5) ◽

pp. 333 ◽

Cited By ~ 6

Author(s):

Chao-Ju Chen ◽

Li-Ling Hsieh ◽

Shu-Kai Lin ◽

Chu-Feng Wang ◽

Yi-Hui Huang ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Severe Acute Respiratory Syndrome ◽

Reverse Transcriptase ◽

Gold Standard ◽

Health Needs ◽

The Novel ◽

Assay Optimization ◽

The World ◽

Polymerase Chain

Coronavirus disease 2019 (COVID-19), the current uncontrolled outbreak of infectious disease, has caused significant challenges throughout the world. A reliable rapid diagnostic test for COVID-19 is demanded worldwide. The real-time reverse transcriptase polymerase chain was one of the most quickly established methods in the novel viral pandemic and was considered as the gold standard for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this report, we illustrate our experience of applying a protocol from the Taiwan CDC and achieving assay optimization in the immediate circumstances to meet the urgent medical and public health needs.

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Comparison of accuracy of lag screw placement in cephalocondylic nails and sliding hip screw plate fixation for extracapsular fractures of the neck of femur

International Orthopaedics ◽

10.1007/s00264-006-0092-0 ◽

2006 ◽

Vol 30 (5) ◽

pp. 320-324 ◽

Cited By ~ 9

Author(s):

A. J. Shyam Kumar ◽

V. Parmar ◽

J. Bankart ◽

S. C. Williams ◽

W. M. Harper

Keyword(s):

Plate Fixation ◽

Screw Placement ◽

Sliding Hip Screw ◽

Neck Of Femur ◽

Lag Screw ◽

Hip Screw

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A pragmatic randomised clinical trial of the effectiveness and cost effectiveness of targeted population screening for low bone mineral density (BMD) in the prevention of neck of femur fractures

http://isrctn.org/> ◽

10.1186/isrctn11021925 ◽

2012 ◽

Author(s):

Lee Shepstone

Keyword(s):

Bone Mineral Density ◽

Clinical Trial ◽

Cost Effectiveness ◽

Bone Mineral ◽

Randomised Clinical Trial ◽

Population Screening ◽

Mineral Density ◽

Neck Of Femur ◽

Low Bone Mineral Density ◽

Femur Fractures

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108 Neck of Femur Fractures: Streamlined Approach to Improve Consenting Practices

British Journal of Surgery ◽

10.1093/bjs/znab259.007 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

O Brown ◽

A Gaukroger ◽

M Raza ◽

R Sturley ◽

M Arnander

Keyword(s):

Risk Factors ◽

Risk Factor ◽

General Medical Council ◽

Mean Value ◽

Medical Council ◽

The Novel ◽

Neck Of Femur ◽

Consent Forms ◽

Femur Fractures ◽

Operative Fixation

Abstract Aim Neck of femur fractures (NOFs) are synonymous with frailty, and successful outcomes are achieved with operative fixation. The United Kingdom’s General Medical Council guidance governing consent highlights the importance of thorough pre-operative discussion of risk with the patient. We aimed to audit consenting practices in NOF patients within our unit against the British Orthopaedic Association’s (BOA) criteria, with the addition of delirium as a risk factor. Method In cycle one all operatively managed NOFs over a two-month period in October-November 2019 were retrospectively reviewed. Consent forms 1 (CF1) and 4 (CF4) were assessed against BOA-endorsed criteria. Our intervention included a standardised sticker detailing 14 important risks was introduced and a departmental seminar on delirium. A second cycle was undertaken from August-October 2020 to close the audit loop Results No consent form documented all BOA-approved risk factors in cycle one (N = 35). Of cycle two’s 35 patients, 70.8% CF1 were completed using the novel sticker. All of these had 100% BOA-approved risk documentation. Consent forms without the sticker in cycle two documented 9/14 risks (mean value). No CF4 had any risks documented in either cycle. Delirium was documented in 51% in total and in 75% patients with CF1. Delirium documentation improved from 2.9% in cycle one to 51.4% in cycle two. Conclusions Clear lapses in operative consenting processes were identified, especially regarding delirium and CF4 documentation. The introduction of a novel consent sticker drastically improved compliance with BOA guidance for CF1. Recognition and departmental education regarding delirium significantly reduced incidence between cycles.

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