Perioperative Complications, Urinary Retention and Aspiration Pneumonia in Patients with Femoral Neck and Trochanter Fractures Under the Multidisciplinary Program A Study at Bone Femoral Neck and Trochanter Fracture Center, Toyama Municipal Hospital

Previous studies have shown better clinical outcomes after total hip arthroplasty (THA) compared to hemiarthroplasty (HA) for displaced femoral neck fracture. However, few studies have focused on the surgical risks of the two procedures. Therefore, we investigated the perioperative complications of HA and THA in femoral neck fracture, using a large nationwide inpatient database. A total of 286,269 patients (281,140 patients with HA and 5129 with THA) with a mean age of 81.7 were enrolled and HA and THA patients were matched by a propensity score to adjust for patient and hospital characteristics. Patients in a matched cohort were analyzed to compare complications and mortality. The systemic complication rate was not significantly different after a propensity score matching of 4967 pairs of patients. However, the incidence of both hip dislocation and revision surgery was more frequent in the THA group (Risk difference (RD), 2.74; 95% Confidence interval (CI), 2.21–3.27; p < 0.001; RD, 2.82; 95% CI, 2.27–3.37; p < 0.001, respectively). There was no significant difference in 30 day in-hospital mortality among the two groups. The risk of dislocation and reoperation was higher for THA than for HA in elderly patients with a femoral neck fracture in this retrospective study using a nationwide database.

Download Full-text

Risk factors of postoperative urinary retention after hip surgery for femoral neck fracture in elderly women

Geriatrics and Gerontology International ◽

10.1111/ggi.12150 ◽

2013 ◽

Vol 14 (3) ◽

pp. 636-639 ◽

Cited By ~ 10

Author(s):

Shohei Tobu ◽

Mitsuru Noguchi ◽

Takeshi Hashikawa ◽

Jiro Uozumi

Keyword(s):

Risk Factors ◽

Femoral Neck ◽

Femoral Neck Fracture ◽

Urinary Retention ◽

Elderly Women ◽

Hip Surgery ◽

Postoperative Urinary Retention ◽

Neck Fracture

Download Full-text

Outcome and complications after dual mobility total hip replacement

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-08-0116 ◽

2012 ◽

Vol 25 (06) ◽

pp. 511-517 ◽

Cited By ~ 6

Author(s):

A. Autefage ◽

T. Dembour ◽

J.-L. Chancrin ◽

P. Guillaumot

Keyword(s):

Aseptic Loosening ◽

Acetabular Component ◽

Acetabular Fracture ◽

Hip Prosthesis ◽

Perioperative Complications ◽

Greater Trochanter ◽

Dual Mobility ◽

Total Hip ◽

Trochanter Fracture

SummaryObjectives: To report the clinical and radiographic outcome of a canine total hip prosthesis with a dual mobility acetabular component, with a minimum of six months follow-up.Methods: The outcome of dogs that underwent primary cemented unilateral dual mobility hip prosthesis surgery by one of the authors for hip dysplasia or trauma, and which had a minimum of six months clinical and radiologic follow-up, was evaluated.Results: Fifty dogs were included in the study. Follow-up ranged from six to 38 months (mean 14.4 months). Perioperative complications were acetabular collapse (n = 1) and greater trochanter fracture (n = 1), both of which were successfully managed perioperatively. Postoperative complications were aseptic loosening of the acetabular component (n = 2; both surgically revised), implant sepsis (n = 3; all explanted), acetabular fracture (n = 1; conservatively managed), greater trochanter fracture (n = 1; conservatively managed) and sciatic neurapraxia (n = 1). No cases of postoperative luxation or femoral implant aseptic loosening were encountered. Outcome was poor for three cases (3 implant sepsis), fair for three cases (including 1 acetabular component loosening and 1 acetabular fracture), and good or excellent for 44 cases (88%).Clinical significance: There were not any cases of postoperative coxofemoral luxation observed in this series of 50 dogs with dual mobility hip prosthesis. Studies with more patients and longer follow-up are needed to confirm the satisfactory results observed to date with this implant.

Download Full-text

Acute urinary retention management in department of emergency urology

Kazan medical journal ◽

10.17750/kmj2015-939 ◽

2015 ◽

Vol 96 (6) ◽

pp. 939-942

Author(s):

A K Abdurakhmanov ◽

V A Kopylov

Keyword(s):

Postoperative Complications ◽

Urinary Retention ◽

Acute Urinary Retention ◽

Treatment Costs ◽

First Episode ◽

Municipal Hospital ◽

Total Treatment Cost ◽

Lower Urinary Tract Infection ◽

Total Treatment ◽

Healthcare Expenses

Aim. Reduce the treatment costs for patients with acute urinary retention, as well as prevention of intra- and postoperative complications. Methods. Since January 1st, 2014 to December 31st, 2014, 3760 patients were examined in the urology department of the Municipal Hospital №5, including 114 (3.2%) patients with acute urinary retention, of whom 100 (2.8%) had the first episode of acute urinary retention, 14 (0.4%) - the relapse. In the first group of 81 (71%) patients with uncomplicated acute urinary retention, a permanent urethral catheter was inserted; patients were further treated as outpatients. The patients of the second group (33 patients, 29%) with complicated acute urinary retention were admitted in the department of urology. The age of the examined patients ranged from 50 to over 80 years, the mean age was 65 years. The analysis of the treatment costs in patients with acute urinary retention was performed, with the treatment costs calculated by the economical department of the Municipal Hospital №5. The average cost of 1-day stay in the department of urology in 2014 was 1416 rubles. Results. The management tactics, allowing to reduce the treatment costs, as well as to reduce the number of intra- and postoperative complications, was proposed. If 100% of patients with acute urinary retention were admitted, the total treatment cost would be 807 120 rubles. The used approach reduced this costs to 118 944 rubles, with the economical effect of 688 176 rubles in 2014. Conclusion. The used strategy of treating patients with acute urinary retention decreases the healthcare expenses on treating this condition, as well as decreases the risk for lower urinary tract infection and excludes the possibility of nosocomial infections.

Download Full-text