scholarly journals Post-operative mortality and factors related to mortality after bipolar hemiarthroplasty in patients with femoral neck fractures

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2604-2608
Author(s):  
Prabhakaran A ◽  
Selvakumar P ◽  
Krishnagopal R ◽  
Anisha Rao
Keyword(s):  
Hip Fractures ◽  
Small Sample Size ◽  
The Elderly ◽  
Small Sample ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Medical College ◽  
Femur Fractures ◽  
Gandhi Medical College ◽  
Surgical Duration

Hip fractures are a common entity in the elderly. Hemiarthroplasty is a common treatment option for displaced neck of femur fractures and have been found to be successful in restoring mobility, reducing pain and improving quality of life following hip fractures in elderly. Many studies have reported that advanced age, male gender, long term stay in the intensive care unit, poor postoperative mobilization ability, a poor or dependent ADL score preoperatively, multiple comorbidities which result in a high ASA score have been associated with higher mortality. A retrospective study was done at the Department of Orthopaedics at Mahatma Gandhi Medical College and Research Institute, Pondicherry which included all patients who underwent hemiarthroplasty (both cemented and uncemented) from 2017-2020. The details of patients satisfying the inclusion criteria were obtained from the medical records department and were analysed by a single investigator. In case the subjects had not reviewed following surgeries, details were obtained by telephonic communication. In our study of 40 patients, mortality was observed in 4 patients which included 3 females and 1 male. It was also observed that mortality was high between the ages of 61-80 years, patients with multiple comorbidities and patients with high ASA scores. The hazard ratio was calculated for 3 parameters namely age, time to surgery and surgical duration and is 1.014, 0.842 and 0.984 respectively but this was not found to be statistically significant. This may due to the small sample size and retrospective nature of our study.

scholarly journals Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

2020 ◽  
Vol 6 (2) ◽  
pp. 333
Author(s):  
Harpreet Singh ◽  
Tej S. Rudani ◽  
Malay P. Gandhi ◽  
Aliasgar J. Rampurwala
Keyword(s):  
Excellent Result ◽  
The Elderly ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Neck Of Femur Fracture ◽  
Uncemented Group

<p class="abstract"><strong>Background:</strong> The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.</p><p><strong>Conclusions:</strong> Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery &amp; complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study. </p>

Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study

Injury ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 1988-1991 ◽  
Author(s):  
S.C. Jonas ◽  
R. Shah ◽  
N. Al-Hadithy ◽  
M.R. Norton ◽  
S.A. Sexton ◽  
...  
Keyword(s):  
Case Control Study ◽  
The Elderly ◽  
Case Control ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Control Study

scholarly journals Similar recovery in mobility and quality of life after cemented and cementless hemiarthroplasty for hip fractures

2021 ◽  
Vol 28 ◽  
pp. 221049172110220
Author(s):  
Toh Ruixiang ◽  
Padki Akshay ◽  
Yew Andy ◽  
Yeo H Shan ◽  
Koh Joyce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hip Fractures ◽  
Retrospective Review ◽  
Hip Prosthesis ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Significant Difference ◽  
Uncemented Hemiarthroplasty

Summary: Patients who suffer hip fractures become immobile with reduced quality of life. Our study aims to assess which cemented or cementless hemiarthroplasty resulted in better mobility or quality-of-life scores. Our retrospective review showed that both have similar scores after matching for age, gender, body mass index and comorbidities. Introduction: Hip fractures have mortality rates of up to 10% at 1 month and 30% at 1 year, as well as significant morbidity. This paper seeks to compare mobility and quality-of-life scores of cemented against uncemented hemiarthroplasty for the displaced neck of femur fractures. Our hypothesis is that there is no difference between the mobility and quality of life of patients treated with cemented or uncemented bipolar hemiarthroplasty. Methods: A retrospective review of registry data on hemiarthroplasties performed in our institution between 2011 and 2019 was conducted. From this dataset, 70 cemented hemiarthroplasties and 238 uncemented hemiarthroplasties were identified. Patients were assessed pre- and post-operatively, at 6 weeks, 3 months, 6 months and 12 months to determine functional recovery through mobility and quality-of-life scores. Results: On propensity score matching, both groups showed a reduction in Parker mobility score from 6.5 to 4 ( p = 0.91), SF-36 physical function scores from 52.5 (cemented) to 30 and 57.5 (uncemented) to 25 ( p = 0.79). Comparing the delta changes from pre-fall after matching, no significant differences were observed. From the analysis of the matched set of data, treatment of neck of femur using cemented or non-cemented bipolar hip prosthesis resulted in similar mobility and quality-of-life scores. Conclusion: In our analysis, there was no statistically significant difference in the mobility or quality-of-life scores of the patients undergoing cemented versus uncemented hemiarthroplasty for the displaced neck of femur fractures.

scholarly journals Treatment of Displaced Femoral Neck Fractures: Unipolar Hemiarthroplasty Versus Bipolar Hemiarthroplasty

KYAMC Journal ◽  
2017 ◽  
Vol 8 (1) ◽  
pp. 10-14
Author(s):  
Md Ashraful Islam ◽  
Md Abdur Rashid ◽  
Md Rafiqul Islam ◽  
Md Masudar Rahman ◽  
Md Asmaul Hossain Khan ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Early Mobilization ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Medical College ◽  
Bipolar Group ◽  
Displaced Femoral Neck Fractures ◽  
Displaced Fracture

Background: Femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty.Objectives: The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients.Methods: Forty-one patients above 60 years of age and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either unipolar or bipolar hemiarthroplasty, in the Department of Orthopaedics at Khwaja Yunus Ali Medical College and Hospital, Enayetpur, Sirajgonj, Bangladesh in between December 2014 and February 2017. Functional outcome was assessed and compared using Harris hip score and radiological parameters with a follow-up of one year.Results: The two groups of patients with mean age of 67.3 in bipolar group and 75.6 in unipolar group did not differ in their pre-injury characteristics and perioperative parameters. The mean Harris hip score in bipolar and unipolar groups was 86.18±12.18 and 79.79±15.55, respectively (p=0.183); range of motion was 210.63±28.39 and 181.58±37(p=0.015) with bipolar and unipolar groups, respectively. Functional activities were better in the bipolar group. Complications like painful hip, posterior dislocation, periprosthetic fracture and acetabular erosion were encountered in unipolar prostheses.Conclusion: The use of bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 10-14

Incidence of Surgical Site Infection Associated with Robotic Surgery

2010 ◽  
Vol 31 (8) ◽  
pp. 822-827 ◽  
Author(s):  
Elizabeth D. Hermsen ◽  
Tim Hinze ◽  
Harlan Sayles ◽  
Lee Sholtz ◽  
Mark E. Rupp
Keyword(s):  
Surgical Site Infection ◽  
Open Surgery ◽  
Small Sample Size ◽  
Academic Medical Center ◽  
Small Sample ◽  
Site Infection ◽  
National Data ◽  
Robot Assisted ◽  
Surgical Duration ◽  
Robot Assisted Surgery

Objective.Robot-assisted surgery is minimally invasive and associated with less blood loss and shorter recovery time than open surgery. We aimed to determine the duration of robot-assisted surgical procedures and the incidence of postoperative surgical site infection (SSI) and to compare our data with the SSI incidence for open procedures according to national data.Design.Retrospective cohort study.Setting.A 689-bed academic medical center.Patients.All patients who underwent a surgical procedure with use of a robotic surgical system during the period from 2000-2007.Methods.SSIs were defined and procedure types were classified according to National Healthcare Safety Network criteria. National data for comparison were from 1992-2004. Because of small sample size, procedures were grouped according to surgical site or wound classification.Results.Sixteen SSIs developed after 273 robot-assisted procedures (5.9%). The mean surgical duration was 333.6 minutes. Patients who developed SSI had longer mean surgical duration than did patients who did not (558 vs 318 minutes; P<.001). The prostate and genitourinary group had 5.74 SSIs per 100 robot-assisted procedures (95% confidence interval [CI], 2.81–11.37), compared with 0.85 SSIs per 100 open procedures from national data. The gynecologic group had 10.00 SSIs per 100 procedures (95% CI, 2.79–30.10), compared with 1.72 SSIs per 100 open procedures. The colon and herniorrhaphy groups had 33.33 SSIs per 100 procedures (95% CI, 9.68–70.00) and 37.50 SSIs per 100 procedures (95% CI, 13.68–69.43), respectively, compared with 5.88 and 1.62 SSIs per 100 open procedures from national data. Patients with a clean-contaminated wound developed 6.1 SSIs per 100 procedures (95% CI, 3.5–10.3), compared with 2.59 SSIs per 100 open procedures. No significant differences in SSI rates were found for other groups.Conclusions.Increased incidence of SSI after some types of robot-assisted surgery compared with traditional open surgery may be related to the learning curve associated with use of the robot.

scholarly journals Selection of Anti-Depressants in Geriatric Dermatoses- A Questionnaire Study of Dermatologists in Western Rajasthan, India

2021 ◽  
Vol 6 (1) ◽  
pp. 01-06
Author(s):  
Dilip Kachhawa ◽  
Hemamalini Narasimhan ◽  
Pankaj Rao
Keyword(s):  
Small Sample Size ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Small Sample ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Study Objective ◽  
Net Worth ◽  
Primary Disorder ◽  
Selection Of

Background: The Global Wealth Migration Review 2019 report, published by New World Wealth, estimated that 48% of India's total wealth was held by high-net worth individuals. Distinct factors dominate the prescription of anti-depressants in the geriatric population. Accordingly, the intention of pharmacotherapy in geriatric psycho dermatoses is deciphered in the study. . Objective: To survey and analyze the selection of anti-depressants by the dermatologists in the practice of geriatric pharmacotherapy. Methods: A questionnaire was designed and circulated among ninety-three dermatologists in three sessions and the data collected was analyzed through the cross-sectional study statistics. Results: The typical senior people attending the specialist were 25-50%. A sizeable familiarity of psycho cutaneous disturbance was attributed to dermatophyte infections, lichen simplex chronic, and Prurigo in descending order. The largely established primary disorder was neurotic excoriation. The prescription pattern was classified and 51.9% dermatologists are customary with psychotropic agent Doxepin over other agents. The discipline of the multidisciplinary approach was also studied. Limitation: Small sample size, uniregional study, prevalence study. Conclusions: The survey aids in evaluating mental health in cutaneous dermatoses of the elderly and assists the dermatologists to offer understated economical options and amend existing guidelines.

scholarly journals Contemporary view of medical care of the elderly people with proximal femur fractures

2021 ◽  
pp. 186-195
Author(s):  
M. V. Belov ◽  
K. Yu. Belova
Keyword(s):  
Medical Care ◽  
Hip Fractures ◽  
Proximal Femur ◽  
Elderly Person ◽  
The Elderly ◽  
Care Organization ◽  
Risk Of Death ◽  
Femur Fractures ◽  
Increased Risk

Fractures of the proximal femur are a severe, life-threatening injury with enormous social, medical and economic consequences. Even with a well-organized system of medical care, up to 12-17% of patients die within the first year after injury, and the long-term risk of death doubles. Specially designed population-based studies in the Russian Federation have shown a high incidence of hip fractures in patients at the age of 50 and older. However, there is currently no unified system of medical care organization for all regions of Russia, which allows hospitalization and operation of patients with hip fractures during the first hours after trauma. Hip fracture in an elderly person is an absolute indication for the hospitalization. However most patients have severe comorbidities, osteoporosis, an increased risk of falls and mortality because of any reason. The main surgical treatments for hip fractures include osteosynthesis of the fracture or hip arthroplasty. It is well known that after the occurrence of any fragility fracture the risk of subsequent fractures increases by 2-3 times. To ensure the continuity of patient management, provide prescription of anti-osteoporotic drugs and long-term follow-up of patients it is necessary to manage them within the special Fracture Liaison Services (FLS). The article is devoted to the organization of medical care in patients of older age groups who have received hip fractures. A review of modern approaches to the treatment and organization of care for elderly patients with hip fractures is based on the methodological recommendations «Complex measures aimed at preventing falls and fractures in the elderly» developed in the framework of the federal project «The Older Generation», the draft national clinical guidelines «Fractures of the proximal femur», as well as the results of our own research.

scholarly journals Dual mobility total hip arthroplasty for salvaging failed internal fixation for neck of femur fractures

2020 ◽  
Vol 27 (1) ◽  
pp. 68-71
Author(s):  
Jatinder Singh Luthra ◽  
Suwailim Al Ghannami ◽  
Salim Al Habsi ◽  
Soubhik Ghosh
Keyword(s):  
Total Hip Arthroplasty ◽  
Internal Fixation ◽  
Hip Fractures ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Neck Of Femur ◽  
Dual Mobility ◽  
Wound Debridement ◽  
Total Hip ◽  
Femur Fractures

Internal fixation is commonly used to treat fractures in the hip. However, failure of proximal femoral fracture fixation is common and treated with total hip replacement (THR). The aim of this study is to present our midterm results of dual mobility (DM) THR for failed internal fixation of proximal femur fractures. Between 2010 and 2015, a total of 28 cases of failed internal fixation for hip fractures were treated through DM total hip arthroplasty. Two patients died during the early postoperative period due to medical complications. The average follow-up was 3.4 years. We had one patient with superficial surgical site infection which was managed by local wound debridement and dressings. The average Harris hip score was 85. DM THR is the procedure of choice for revising failed internal fixation for hip fractures in our patients with good clinical outcome.

scholarly journals The nature of language problem in Bangladeshi children with cerebral palsy: an observation using neurolinguistic approach

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 22-27
Author(s):  
F Ferdous ◽  
MF Alam ◽  
MMR Chisty ◽  
JI Ali ◽  
NMW Rahman
Keyword(s):  
Cerebral Palsy ◽  
Small Sample Size ◽  
Tertiary Care ◽  
Small Sample ◽  
Childhood Disability ◽  
Medical College ◽  
Complex Sentences ◽  
History Of ◽  
Children Development ◽  
Tertiary Care Hospitals

Cerebral palsy (CP) is the leading cause of childhood disability affecting function and development. The objective of the study was to look into the language problems in Bangladeshi children with CP on the basis of neurolinguistic approach and was conducted during the period of April 2014 to December 2014 at the Department of Linguistics, University of Dhaka among children aged between 3 to 18 years. In the study, a total of 10 children with CP were enrolled purposively from two tertiary care hospitals in Dhaka (Children Development Centre of Sir Salimullah Medical College and Mitford Hospital and National Institute of Mental Health). The mean±SD age was 8.9±4.8 years. Male was predominant (60.0%). History of prolonged labour was 100%, and home attended by untrained birth attendants in 70.0%. The 90.0% of the children understood simple meaningful sentences using two words. The children were unable to understand complex sentences. The 80.0% children did not want to play or make friendship with other children; 40.0% did not understand others’ speech, 50.0% did not express their own speech, and 10.0% did not understand & express their own speech. All the children had deep thong articulation changed to mono thong in case of semi vowel articulation. In case of history of delayed crying at birth, phoneme omission occurred when the children tried to articulate any word. To the best of knowledge, this was the first study done on the neurolinguistic approach in Bengali children, but the limitation of the study were that it was with small sample size, city based and short duration. Therefore, generalization of the results would be difficult. Further studies using larger sample would be better to visualize the extent of the issue in order to insert the children with CP in their social context and to give them quality of life.Mediscope Vol. 5, No. 1: Jan 2018, Page 22-27

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