scholarly journals Mortality and morbidity of proximal femur fractures in elderly population – A three year follow-up study

2020 ◽  
Vol 6 (2) ◽  
pp. 69-72
Author(s):  
Sandeep Krishna Avulapati ◽  
◽  
Avinash Bajjuri ◽  
Sunil Boddu ◽  
Anudeep Peddineni ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Elderly Population ◽  
Mortality And Morbidity ◽  
Proximal Femur Fractures ◽  
Follow Up Study ◽  
Femur Fractures

scholarly journals Hyponatremia in elderly patients with fragility fractures of the proximal femur: a cross-sectional study

2019 ◽  
Vol 41 (4) ◽  
pp. 518-525
Author(s):  
Aída Fernanda Batista Rocha ◽  
Marcus Villander Barros De Oliveira Sá ◽  
Ubirace Fernando Elihimas Junior
Keyword(s):  
Proximal Femur ◽  
Fragility Fractures ◽  
Cross Sectional Study ◽  
Electrolyte Balance ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Elderly Individuals ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Balance Disorder

ABSTRACT Introduction: Proximal femur fractures affect the mortality and morbidity of elderly individuals. Recent studies have shown an association between fragility fractures and hyponatremia, a common fluid and electrolyte balance disorder. Objectives: This study aimed to investigate the occurrence of hyponatremia in patients with fragility fractures of the proximal femur. Methods: The authors looked into the data from the medical records of patients admitted to the emergency unit of the Real Hospital Português for fragility fractures of the proximal femur from 2014 to 2017. The study included patients with serum sodium levels recorded in their charts. Results: Fourteen of 69 (20.3%) patients with proximal femur fractures had hyponatremia. The main factors linked to hyponatremia were lung disease, and prescription of amiodarone and/or antidepressants. Conclusion: In elderly individuals, fragility fractures of the proximal femur may correlate with hyponatremia, particularly among patients on amiodarone or antidepressants.

How Safe and Time Consuming is the Surgical Training of Young Orthopaedic Surgeons? A Retrospective Analysis of Proximal Femur Fractures

2021 ◽  
Author(s):  
Konrad Schütze ◽  
Carlos Pankratz ◽  
Alexander Eickhoff ◽  
Florian Gebhard ◽  
Peter Richter
Keyword(s):  
Surgical Training ◽  
Proximal Femur ◽  
Surgical Complications ◽  
Elderly Population ◽  
Operating Time ◽  
The Elderly ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Surgical Trainees ◽  
Tip Apex Distance

Abstract Background Fractures of the proximal femur in the elderly population are rising. Teaching the appropriate surgical treatment of these fractures is of paramount importance. The aim of the study was to evaluate differences in outcome of surgical procedures between supervised trainees and senior surgeons. Objective Are there more surgical complications, poorer quality or an increased operating time if the procedure (in this case: fixation of proximal femur fractures) is performed by trainees under supervision in comparison to experienced surgeons. Material and Methods All patients treated with the proximal femur nail antirotation (PFNA) between 2015 and 2016 at a level one trauma centre were included in this study. The retrospective review of the 299 patients compared supervised surgical trainees and senior surgeons. Parameters included operating time, tip apex distance, position of the blade, Hb-difference, transfusion rate, surgical complications as well as mortality, and were compared between the groups. Results 153 of 299 procedures were performed by supervised surgical trainees. In comparison to senior surgeons, there was no significant difference in operating time (WA 54.48 min; OA 60.47 min; p > 0,05), Hb-difference (WA 2.8 g/dl; OA 2.6 g/dl; p > 0.05), tip-apex distance (WA 21.2 mm; OA 20.5 mm, p = 0.37) or rate of surgical complications. There was no difference in the rate of optimal blade positions between the groups (WA 87.5%; OA 89.0%; p = 0.366). Furthermore, mortality showed no difference between the groups, but was greater in older patients or high ASA grade. Conclusion Supervised surgical training during treatment of proximal femur fractures shows no increase in operating time, complications or mortality and no difference in quality. With the fast growth of the elderly population, surgical training of fragility fractures should receive more attention in the future.

scholarly journals TO EVALUATE THE EFFICACY OF KICK STAND SCREW IN FIXATION OF SUBTROCHANTERIC FEMORAL FRACTURES USING CONTRALATERAL REVERSED DISTAL FEMORAL LOCKING PLATEPROSPECTIVE SINGLE CENTRIC STUDY

2020 ◽  
pp. 1-4
Author(s):  
Prashant Pandey ◽  
K K Pandey ◽  
Ajay Dhanopeeya ◽  
Surya Prakash Garg
Keyword(s):  
Proximal Femur ◽  
Locking Plate ◽  
Harris Hip Score ◽  
Plate Bending ◽  
Neck Shaft Angle ◽  
Subtrochanteric Fractures ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Shaft Angle

PURPOSE- All type of plates when used for proximal femur fractures always has chances of mechanical failure due to lack of strength of the construct, but addition of ‘kick stand screw’ has some effects on stability of the construct. Aim of our study is to evaluate the efficacy of kick stand screw in fixation of subtrochanteric fractures using contralateral reversed distal femoral locking plate. METHOD- 30 patients of subtrochanteric fractures fixed using contralateral reversed distal femoral locking plate. N(1st)=15 fixed without kick stand screw and other N(2nd)=15 fixed using kick stand screw. Calcar screw( Kick Stand Screw) is placed to support calcar region (inferior to the center in AP view and central in Lateral view). In other group screws are placed as oriented in screw holes. Outcome was assessed using Harris Hip Score and VAS score and change in the neck shaft angle is also followed. RESULT- Union rate was 80% in 1st group as compare to 94% in second group. Mean Harris hip score at the one year follow up was 71.2 in 1st group as compare to 89.2 in 2nd group. Mean Visual analogue scale was 3.2 in first group as compare to 1.6 in second group at final follow up. Mean neck shaft angle at final follow-up was 120 degree in first group as compared to135 degree in second group. Complication- 1st Group of patients had three failures 2 in the form of screw break down and one in the form of plate bending, all three lend up in to varus deformity but the 2nd group had only one failure in the form of plate bending. CONCLUSION-In our study cases in which kick stand screw was used they showed better mechanical strength and gave better clinical results. So in proximal femur fractures including subtrochanteric fracture fixation ‘kick stand screw’ must be used.

scholarly journals Mortality Following Distal Femur Fractures Versus Proximal Femur Fractures in Elderly Population: The Impact of Best Practice Tariff

Cureus ◽  
2020 ◽  
Author(s):  
Islam Mubark ◽  
Amr Abouelela ◽  
Ahmed Genena ◽  
Abdallah Al Ghunimat ◽  
Islam Sarhan ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Best Practice ◽  
Elderly Population ◽  
Distal Femur ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
The Impact

scholarly journals Surgical management of pertrochanteric fractures with proximal lateral femur locking compression plate

2016 ◽  
Vol 2 (4) ◽  
pp. 234
Author(s):  
Biju R. ◽  
Kumar Babu B.L.S. ◽  
Sarat Chandra M.
Keyword(s):  
Proximal Femur ◽  
Weight Bearing ◽  
High Stress ◽  
Locking Compression Plate ◽  
Full Weight Bearing ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Compression Plate ◽  
Type 3

<p><strong>Background:</strong> Pertrochanteric femoral fractures are of intense interest globally. Pertrochanteric fracture is a one of the most serious cause of mortality and morbidity in elderly people. The number of such admissions is on a raise because of increasing life span, sedentary habits and increased road traffic accidents. Pertrochanteric region is a high stress area. Hence delayed union, implant failures, varus collapse and non-union are common complications. Choice of implant was also a tough decision for surgeons in this area. Hence this study was intended to evaluate the functional outcome of proximal femur fractures treated with proximal femur locking compression plate (PFLCP) in terms of union of fracture, patient compliance and complications.</p><p><strong>Methods:</strong> This prospective study was conducted at the department of orthopaedics, Narayana Medical College and Hospital, Nellore from December 2014 to June 2016. The complete data was collected from all the patients by taking history of illness and by doing detailed clinical examination and relevant investigations. Finally after the diagnosis, the patients were selected for the study depending on the inclusion and exclusion criteria. Postoperatively all the cases were followed for the minimum period of 6 months to maximum period of 1 year.</p><p><strong>Results: </strong>In this study 22 patients were involved. There were 14 males and 8 females, with a mean age of 46 years. 19 cases were admitted due to slip and fall and with slight predominance of right side. Mean duration of hospital stay was 20 days and mean time of full weight bearing is 10 weeks. Out of 22 cases 2 cases lost follow up before first follow up time of 6 weeks. Out of 20, remaining cases 8 were type 3 and 12 were type 4. Functional results were graded by Harris hip scoring system. Good to excellent results were seen in 87% cases of type 3 fractures and 83% cases in type 4 fractures.</p><strong>Conclusions: </strong>Treatment with a PFLCP can provide good-to-excellent healing for proximal femur fractures, with a limited occurrence of complications especially for severe comminuted fracture and osteoporosis.

Outcome of non-surgical treatment of proximal femur fractures in the fragile elderly population

Injury ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1347-1352 ◽  
Author(s):  
Tal Frenkel Rutenberg ◽  
Aseel Assaly ◽  
Maria Vitenberg ◽  
Shai Shemesh ◽  
Alon Burg ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Proximal Femur ◽  
Elderly Population ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Non Surgical Treatment

scholarly journals The PFNA® Augmented in Revision Surgery of Proximal Femur Fractures

2014 ◽  
Vol 8 (1) ◽  
pp. 232-236 ◽  
Author(s):  
Alexander Scola ◽  
Florian Gebhard ◽  
Christoph Dehner ◽  
Götz Röderer
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Revision Surgery ◽  
Cement Leakage ◽  
Clinical Results ◽  
Proximal Femur Fracture ◽  
Bone Stock ◽  
Proximal Femur Fractures ◽  
Femur Fractures

Objectives: Modern implants for proximal femur fracture treatment have clearly improved clinical results. However, complications, including cut-out and loss of reduction, requiring revision surgery still occur. A major challenge in these cases is a loss of bone stock due to the existing implant, which is usually exacerbated by osteoporosis. A potential solution is the augmentation of implants, for example, of the femoral neck blade using bone cement. Materials and Methods: Ten patients (five loosening of femoral neck implant, two pseudarthrosis, two implant failures and one acute fracture) were included. The initial hardware was removed and a PFNA augmented was implanted. The perforated femoral neck blade was augmented using polymethyl methacrylate cement. Clinical and radiological follow-up was performed at a mean of 5.4 months (SD ±4.34). The main outcome parameters were fracture healing and implant-related complications. Results: Technical handling was uneventful in all cases. No cement leakage into the joint occurred in any of the cases. The mean amount of cement injected was 5.3 ml. The fracture healed during follow-up in all cases except two patients who died from causes unrelated to the procedure and prior to complete consolidation. Problem-free elective hardware removal of the PFNA augmented was performed in two cases. Discussion: The PFNA augmented is a potential implant for joint-preserving revision surgery in proximal femur fractures. The augmentation improves implant anchorage in the impaired bone stock. In this preliminary series, no negative biological side effects of the cement (i.e. osteonecrosis) were observed.

scholarly journals Geriatric Proximal Femur Fractures During the Covid-19 Pandemic - Fewer Cases, But More Comorbidities

2021 ◽  
Vol 12 ◽  
pp. 215145932110096
Author(s):  
Christina Polan ◽  
Heinz-Lothar Meyer ◽  
Manuel Burggraf ◽  
Monika Herten ◽  
Paula Beck ◽  
...  
Keyword(s):  
Nursing Home ◽  
Elderly Patients ◽  
Proximal Femur ◽  
Minor Trauma ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Number Of Patients ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Background: The COVID-19 pandemic is challenging healthcare systems worldwide. This study examines geriatric patients with proximal femur fractures during the COVID-19 pandemic, shifts in secondary disease profile, the impact of the pandemic on hospitalization and further treatment. Methods: In a retrospective monocentric study, geriatric proximal femur fractures treated in the first six months of 2020 were analyzed and compared with the same period of 2019. Pre-traumatic status (living in a care home, under supervision of a legal guardian), type of trauma, accident mechanism, geriatric risk factors, associated comorbidities, time between hospitalization and surgery, inpatient time and post-operative further treatment of 2 groups of patients, aged 65-80 years (Group 1) and 80+ years (Group 2) were investigated. Results: The total number of patients decreased (70 in 2019 vs. 58 in 2020), mostly in Group 1 (25 vs. 16) while the numbers in Group 2 remained almost constant (45 vs. 42). The percentage of patients with pre-existing neurological conditions rose in 2020. This corresponded to an increase in patients under legal supervision (29.3%) and receiving pre-traumatic care in a nursing home (14.7%). Fractures were mostly caused by minor trauma in a home environment. In 2020, total number of inpatient days for Group 2 was lower compared to Group 1 (p = 0.008). Further care differed between the years: fewer Group 1 patients were discharged to geriatric therapy (69.6% vs. 25.0%), whereas in Group 2 the number of patients discharged to a nursing home increased. Conclusions: Falling by elderly patients is correlated to geriatric comorbidities, consequently there was no change in the case numbers in this age group. Strategic measures to avoid COVID-19 infection in hospital setting could include reducing the length of hospital stays by transferring elderly patients to a nursing home as soon as possible and discharging independent, mobile patients to return home.

Durability of Hemiarthroplasty for Pathologic Proximal Femur Fractures

2017 ◽  
Vol 32 (12) ◽  
pp. 3607-3610 ◽  
Author(s):  
Matthew T. Houdek ◽  
Cody C. Wyles ◽  
Joshua R. Labott ◽  
Peter S. Rose ◽  
Michael J. Taunton ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Proximal Femur Fractures ◽  
Femur Fractures
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