Application of oxycodone combined with intravenous inhalation anesthesia in pfna internal fixation of femoral intertrochanteric fracture in the elderly

Objective: The effect of prospective nursing to lower deep vein thrombosis afer the internal fixation of femoral intertrochanteric fracture was studied. Method: 80 patients, who treated with the internal fixation of femoral intertrochanteric fracture in the orthopedics department of our hospital between January 2012 and June 2013 were selected, the patients were randomly allocated to control group and test group, 40 cases per group, the control group were treated by conventional nursing measures, while the test group used the prospective nursing measures. Compared the living quality and the lower deep vein thrombosis of two groups. Results: For the living quality, the scores of all items in prospective nursing group were better than conventional nursing group. The number of lower deep vein thrombosis in the prospective nursing group was 2 cases and the conventional nursing group was 8 cases, with statistical difference. Conclusion: The prospective nursing could reduce the incidence of lower deep vein thrombosis after the internal fixation of femoral intertrochanteric fracture, improved the living quality of such patients after surgery, worth clinical promotion.

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The Perioperative Nursing of Treating the Elderly Patients of Femoral Intertrochanteric Fracture with PFNA

Journal of Nursing ◽

10.18686/jn.v4i1.1 ◽

2015 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Ying Zhang

Keyword(s):

Elderly Patient ◽

Elderly Patients ◽

Intertrochanteric Fracture ◽

Perioperative Period ◽

The Elderly ◽

Good Recovery ◽

Surgical Risk ◽

Perioperative Nursing ◽

Femoral Intertrochanteric Fracture ◽

Pull Through

Objective: Summarize the perioperative nursing of the elderly patient of femoral intertrochanteric fracture. Method: Retrospectively analyze the preoperative preparations as well as the postoperative nursing of treating the 75 elderly patients of femoral intertrochanteric fracture with PFNA. Results: Those 75 patients all pull through perioperative period and their functions are in good recovery. Conclusion: The elderly patient of femoral intertrochanteric fracture has much surgical risk together with many complications during perioperative period. Adopting effective comprehensive nursing can improve the treatment effect of the operation, and can also reduce the complications.

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Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2793-8 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 4

Author(s):

Shenghu Zhou ◽

Jun Liu ◽

Ping Zhen ◽

Weiwei Shen ◽

Yanfeng Chang ◽

...

Keyword(s):

Postoperative Complications ◽

Elderly Patients ◽

Intertrochanteric Fracture ◽

Operation Time ◽

The Elderly ◽

Proximal Femoral Nail ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Intraoperative Bleeding ◽

Femoral Intertrochanteric Fracture

Abstract Background The treatment for unstable intertrochanteric fractures in the elderly has always been a controversial issue. The aim in this study was to compare the curative effects of proximal femoral nail anti-rotation (PFNA) and cementless bipolar hemiarthroplasty (CPH) on femoral intertrochanteric fracture in the elderly. Methods From March 2008 to December 2012, 108 elderly patients with femoral intertrochanteric fractures were treated by PFNA or CPH. There were 63 males and 45 females, aged 75.3–99.1 years [(83.7 ± 5.6) years]. The patients’ bone mineral density was routinely measured, and the fractures were classified according to Evans-Jensen. The patients were divided into CPH group and PFNA group. The differences in operation time, intraoperative bleeding, immobilization duration, hospitalization time, Harris scores and postoperative complications including deep venous thrombosis, lung and urinary infection were analyzed. Results All patients were followed for 12.5–36.2 months [(28.0 ± 6.3) months)]. The operation time was (53.7 ± 15.2) min and (77.5 ± 16.8) min in PFNA group and CPH group, respectively (P < 0.05); intraoperative bleeding was (132.5 ± 33.2) mL and (286.3 ± 43.2) mL, respectively (P < 0.05); immobilization duration was (28.2 ± 3.7) days and (3.1 ± 1.2) days, respectively (P < 0.05); hospitalization time was (7.6 ± 1.8) days and (6.9 ± 2.2) days, respectively (P > 0.05); and the Harris scores after 1 year were (87.7 ± 7.9) points and (88.3 ± 9.2) points, respectively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). Conclusion Both PFNA and CPH are safe and effective treatments for femoral intertrochanteric fracture in elderly patients. Nonetheless, CPH allows faster mobilization and recovery. Trial registration Registration Number: ChiCTR1900022846. Reg Date:2019-04-26 00:27:33 Retrospective registration

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Primary bipolar replacement arthroplasty versus internal fixation in the management of unstable intertrochanteric fractures in the elderly

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195803 ◽

2019 ◽

Vol 6 (1) ◽

pp. 111

Author(s):

Abhishek Bansal ◽

Rajendra Kumar Beniwal ◽

Saumya Agarwal

Keyword(s):

Internal Fixation ◽

Intertrochanteric Fracture ◽

Weight Bearing ◽

Early Mobilization ◽

The Elderly ◽

Medical Illness ◽

Sliding Hip Screw ◽

Replacement Arthroplasty ◽

Hip Screw ◽

Intertrochanteric Femur Fracture

Background: Management of unstable intertrochanteric femur fracture in the elderly has been always a matter of debate. There has been always a dilemma between osteosynthesis and prosthesis.Methods: We retrospectively evaluated, 108 osteoporotic elderly patients with unstable intertrochanteric for internal fixation versus primary bipolar replacement arthroplasty in a span of 4 years.Results: Bipolar replacement arthroplasty gives better outcome as compared to internal fixation with sliding hip screw.Conclusions: It was found that cemented bipolar arthroplasty is the choice in freely mobile elderly osteoporotic comminuted displaced intertrochanteric fracture, though is a surgically demanding technique, it spares the postoperative complication of non-weight bearing after internal fixation of these fracture. The internal fixation is also compounded by osteoporosis, medical illness, difficulty to achieve and maintain reduction of comminuted and widely displaced unstable fractures, which restricts the mobilization and weight bearing and further increase the risk of morbidity and mortality in elderly in comparison to cemented bipolar replacement arthroplasty which allows early mobilization and weight bearing.

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

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459321998614 ◽

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.

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

International Orthopaedics ◽

10.1007/s00264-021-05027-z ◽

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

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Conservatively Treated Femoral Intertrochanteric Fracture With Early Asymptomatic Novel Coronavirus Disease 2019 (COVID-19): A Case Report

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151459320969380 ◽

2020 ◽

Vol 11 ◽

pp. 215145932096938

Author(s):

Yuki Suzuki ◽

Toshihiko Kasashima ◽

Kazutoshi Hontani ◽

Yasuhiro Yamamoto ◽

Kanako Ito ◽

...

Keyword(s):

Intertrochanteric Fracture ◽

Screening Method ◽

Oxygen Demand ◽

Japanese Woman ◽

Trauma Patients ◽

Lung Field ◽

Old Japanese ◽

Femoral Intertrochanteric Fracture ◽

Novel Coronavirus ◽

The Right

Introduction: The ongoing outbreak of novel coronavirus disease 2019 (COVID-19) is a worldwide problem. Although diagnosing COVID-19 in fracture patients is important for selecting treatment, diagnosing early asymptomatic COVID-19 is difficult. We describe herein a rare case of femoral intertrochanteric fracture concomitant with early asymptomatic novel COVID-19. Case presentation: An 87-year-old Japanese woman was transferred to our emergency room with a right hip pain after she fell. She had no fever, fatigue, or respiratory symptoms on admission and within the 14 days before presenting to our hospital, and no specific shadow was detected in chest X-ray. However, chest computed tomography (CT) was performed considering COVID-19 pandemic, and showed ground-glass opacities with consolidation in the dorsal segment of the right lower lung field. Then, qualitative real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was carried out and turned out to be positive. She was diagnosed right femoral intertrochanteric fracture with concomitant COVID-19 infection. Conservative treatment was applied to the fracture due to infection. After admission, fever and oxygen demand occurred but she recovered from COVID-19. Throughout the treatment period, no cross-infection from the patient was identified in our hospital. Conclusion: This case highlights the importance of considering chest CT as an effective screening method for infection on hospital admission in COVID-19-affected areas, especially in trauma patients with early asymptomatic novel COVID-19.

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