scholarly journals The Interdependence of Medical-Epidemiological and Anamnestic Characteristics of Patients with Proximal Femur Fractures

2020 ◽  
Vol 5 (5) ◽  
pp. 105-117
Author(s):  
T. S. Hurbanova ◽  
◽  
Keyword(s):  
Functional Status ◽  
Functional State ◽  
Proximal Femur ◽  
Functional Condition ◽  
Weak Correlation ◽  
Proximal Femur Fractures ◽  
Asa Classification ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
One Year

Many studies have confirmed that the incidence of fractures of the proximal femur increases significantly with age and doubles every ten years after the age of 50. It was found out that these patients average age increases by one year every five years, and more than 50.00% with damage to this location are over 60 years old. The purpose of the study was to determine the regional correlation features of the interdependence of medical-epidemiological and anamnestic characteristics of patients with proximal femur fractures. Material and methods. To achieve the main goal, we conducted a retrospective study of patients with such fractures according to seven medical institutions in Kharkiv. Results and discussion. When studying the correlation levels of interdependence between various medical-epidemiological and anamnestic characteristics of the examined patients we stated that the female sex correlated with all age periods, which confirmed the predominance of females among the examined all age categories: the sex of patients determined reliable (average <0.001); forces correlation with age characteristics: k = 0.349; the possible influence of gender characteristics on the choice of treatment tactics was stated reliable (p = 0.003); the inverse weak correlation with the type of treatment was recorded: k = -0.041; the possibilities of the influence of age characteristics on comorbid burden; the presence of concomitant pathology and the choice of treatment tactics were clarified: it was determined that the age of the examined patients was significantly (p = 0.014) inversely weakly correlated with the presence of comorbidities and comorbid burden (respectively k = -0.050 (p < 0.001) and k = -0.047 (p <0.001)) and the type of treatment: k = -0.193 (p <0.001); possibilities of influence of more significant comorbid burden on indicators of levels of functional condition and increase in duration of terms of receipt to traumatological departments and reception of qualitative medical care were established: reliable (p <0.001) direct weak correlation was received between indicators of age of trauma and presence of concomitant diseases k = 0.081), comorbid load (k = 0.087) and functional state according to the ASA classification (k = 0.084); determined the stable effect of the existing concomitant pathology and comorbid burden at the level of functional status and its possible impact on using conservative treatment: the presence of comorbidities correlated strongly with comorbid burden (k = 0.989, p <0.001); functional state was evaluated according to ASA classification k = 0.985, p <0.001) and directly weak with the type of treatment (k = 0.228, p <0.001); a direct strong correlation was found between the comorbid burden and functional status according to the ASA classification and the type of treatment performed (respectively k = 0.979 and k = 0.226; p <0.001); the possible influence of low functional state on the choice of treatment tactics was stated: it was proved that the functional state significantly weakly correlated with the type of treatment: k = 0.229, p <0.001. Further research is planned to establish the possibility of predicting the use of treatment tactics and the development of reliable prognostic statistical models of the dependence of the results of different treatment methods on the medical-epidemiological and anamnestic characteristics of patients

scholarly journals Treatment of Proximal Femur Fractures on the Background of Osteoporosis

2004 ◽  
Vol 11 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A F Lazarev ◽  
E I Solod ◽  
A O Ragozin ◽  
M G Kakabadze ◽  
A F Lazarev ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Femoral Neck Fractures ◽  
Mineral Density ◽  
Stable Fixation ◽  
Fracture Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Choice Of Treatment ◽  
Density Evaluation

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

MEDICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF PROXIMAL FEMUR FRACTURES IN CITY OF KHARKIV AND KHARKIV REGION POPULATION

2020 ◽  
pp. 81-88
Author(s):  
T. S. Hurbanova
Keyword(s):  
Functional Status ◽  
Proximal Femur ◽  
Significant Proportion ◽  
Sex Characteristics ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Sexual Characteristics ◽  
The Right ◽  
Epidemiological Characteristics

Regional clinical and epidemiological characteristics of the patients with the proximal femur fractures have been determined. To perform the research, the following tasks were solved: to establish the prevalence of fractures of the proximal femur depending on age and sex characteristics, place of residence, lesion, features of admission to the clinic, mechanisms of referral, timing of admission, concomitant pathology and comorbid burden, functional level, type of fracture and treatment tactics. The regional epidemiological characteristics of patients with these fractures were retrospectively studied using the date of seven medical institutions of the city of Kharkiv during 2011−2016. The predominance of women with a total average age of all the patients of 70.36±0.20 years and the one of the contingent of the patients aged 71−80 years and older 80 years and older were found. There was a significant prevalence of urban dwellers among the patients. The predominance of patients admitted to trauma departments by ambulance crews was determined. It was stated that the vast majority of respondents received medical care in the first 6 hours after injury. A significant proportion of comorbidly burdened patients with a predominance of the patients with one or two concomitant diseases was identified. Almost identical injuries of both the right and left extremities with a significant predominance of closed fractures and those of type 31A1 and 31B1 according to the classification of the Society for the Study of Osteosynthesis. A certain decrease in functional status was determined according to the classification of the American Society of Anesthesiologists. Conservative treatment was used more often than surgical treatment. Key words: proximal femur fractures, clinical and epidemiological characteristics, concomitant pathology, comorbid burden, age−sexual characteristics, functional status.

scholarly journals APPROACH TO PROXIMAL FEMUR FRACTURES TREATMENT

2017 ◽  
Vol 2 (3) ◽  
pp. 63-68
Author(s):  
SV V Ardatov ◽  
AS S Pankratov ◽  
DA A Ogurtsov ◽  
DS S Shitikov ◽  
YuD D Kim ◽  
...  
Keyword(s):  
Functional State ◽  
Proximal Femur ◽  
Therapeutic Approach ◽  
Geriatric Patients ◽  
Proximal Femur Fractures ◽  
Femur Fractures

Aim - to describe the approach to proximal femur fractures treatment in geriatric (elderly and senile) group of patients. Materials and methods. The article presents the analysis of 16 years’ experience of using both classic and author’s technologies according to the developed classification of patient’s functional state. Conclusion. The decision on therapeutic approach for geriatric patients was optimized.

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

scholarly journals Role of cephalomedullary nail in proximal femur fractures

2017 ◽  
Vol 3 (5) ◽  
pp. 929
Author(s):  
Nishant Kumar ◽  
Dhruv Sharma ◽  
Kuljit Kumar
Keyword(s):  
Hip Fractures ◽  
Proximal Femur ◽  
Femoral Fractures ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cephalomedullary Nail ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Bending Loads ◽  
Cephalomedullary Nails

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Hip fractures are recognized to be a major public health problem. Key determinants of hip fractures include age, osteoporosis, and falls. In these determinants socioeconomic status, have not been well explored. Under eccentric loading, high bending loads occur, leading to failure of the osteosynthetis anchorage at the center of the femoral head.The introduction of the reconstruction nail has broadened the indications for the intramedullary fixation of difficult femoral fractures. The operative technique is however complicated. Some technical difficulties encountered during its use are presented together with guidance to allow these problems to be avoided.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This Study had included 47 cases which were operated by single surgeon and use of different implant (cephalomedullary nail) was randomized irrespective of fracture types and pattern. This study was done over a period of 12 months (October 2013 to October 2014) with 1 month, 3 months, 6 months, 12 months follow up. At every visit patient were assessed as per Oxford hip score. Type of implant used was<strong> </strong>PFNA<strong>,</strong> Intertan<strong>, </strong>Sirus Nail</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The mean age of the patients was 65.68 (±13.55) years. Severe pain was observed among majority of the patients at one month (70.2%) which became mild (40.4%) and moderate (34%) at 3 months. Very mild pain was found in 36.2% patients at 6 months and in 61.7% at 12 months. The limping was all the time among all the patients at one month. However, the limping was found often in 46.8% at 3 months and sometimes in 57.4% at 6 months and 53.2% at 12 months. The hip score was found to be severe among all the patients at one month. However, moderate to severe hip was in 46.8% patients at 3 months, mild to moderate was in 57.4% at 6 months and satisfactory joint function was in 68.1% at 12 months. The comparison of Hip score according to long or short nail at one 3, 6 and 12 months showed no difference. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Cephalomedullary nails with adequate technique so that the lag screws by purchase in the centre-centre or posterior-inferior quadrant combines the benefit of sliding hip screw as well as intramedullary implants. So we recommend the use of cephalomedullary nails in proximal femur fractures especially the unstable fractures.</span></p>

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 Bone remodeling features in elderly and senile patients with the proximal femur fractures after hip replacement

2020 ◽  
Vol 73 (2) ◽  
pp. 259-265
Author(s):  
Oleksandr M. Khvysyuk ◽  
Volodymyr O. Babalian ◽  
Serge B. Pavlov ◽  
Galina B. Pavlova
Keyword(s):  
Treatment Outcome ◽  
Proximal Femur ◽  
Enzyme Linked Immunosorbent Assay ◽  
Regulatory Pathways ◽  
Proximal Femur Fractures ◽  
Femur Fractures ◽  
Results Of Treatment ◽  
Group 2 ◽  
Tgf Β1 ◽  
Group 1

The aim of this study is to identify the dependence of the result of surgical treatment of patients of elderly and senile age with fractures of the proximal femur on the characteristics of the response cytokine-mediated regulatory response to trauma and surgery. Materials and methods: In 74 patients after hip arthroplasty, serum levels of bone metabolism markers were determined using enzyme-linked immunosorbent assay. Patients were divided into 2 groups depending on the results of treatment. Results: It was found that compared with group 2 (treatment outcome is worse) in group 1 (treatment outcome is better) there was a greater number of correlations. In group 1, correlations were found between OPG and RANKL (r = 0.88; p = 0.000), OPG and OPG/RANKL (r = 0.44; p = 0.006), TGF-β1 and OPG/RANKL (r = 0.66; p = 0.000) , IL-6 and OPG (r = 0.67; p = 0.000), IL-6 and RANKL (r = 0.53; p = 0.001), IL-6 and OPG/RANKL (r = 0.39; p = 0.016). In group 2, only between OPG and OPG/RANKL (r = 0.72; p = 0.000), RANKL and OPG/RANKL (r = −0.53; p = 0.0007). In patients of group 2, there was a decrease in the level of OPG relative to the control and a less significant increase in TGF-β1 and IL-6 relative to group 1. Conclusion: The prognosis of the results of treatment of patients with proximal femur fractures is largely determined by the nature of the adaptive response to injury and the implant, the synchronism of the mechanism of stress remodeling of the bone. A less favorable prognosis after arthroplasty is associated with exacerbation of the initial metabolic disorders in the bone tissue due to severe cytokine-mediated dysfunction of the regulatory pathways.

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