scholarly journals Simultaneous Bilateral Hip Fractures in an Elderly Patient in the Absence of Bone Disease: A Case Report

2022 ◽  
Vol 5 (1) ◽  
pp. 01-03
Author(s):  
Ahmed Ayman Habis ◽  
Gavin CA Wood
Keyword(s):  
Hip Fractures ◽  
Perioperative Management ◽  
Early Recognition ◽  
Perioperative Complications ◽  
Bipolar Hemiarthroplasty ◽  
Emergency Team ◽  
Energy Mechanism ◽  
Cardiopulmonary Complications ◽  
Bilateral Hip Fractures ◽  
Cemented Bipolar Hemiarthroplasty

Case: Eighty-three years old female patient who sustained a simultaneous bilateral hip fractures after a mechanical fall. The bilateral nature of the problem was not appreciated by the emergency team and was found after the orthopedic consultation. The patient underwent a single stage bilateral cemented bipolar hemiarthroplasty without perioperative complications. Conclusion: Simultaneous bilateral hip fractures in elderly are not commonly encountered after a low energy mechanism but early recognition of this diagnosis is important to optimize perioperative management. Having bilateral cemented stems did not lead to any significant cardiopulmonary complications as can often be concerned with so called cement syndrome.

scholarly journals PERIOPERATIVE MANAGEMENT AND OUTCOME OF HIP FRACTURES DURING THE COVID-19 PANDEMIC

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Camblor Valladares ◽  
L Lanuza Lagunilla ◽  
P J Suárez-Anta Rodríguez ◽  
A Meneses Gutiérrez ◽  
A García Arias ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Waiting Time ◽  
Hip Fractures ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Tertiary Hospital ◽  
Mean Waiting Time ◽  
The Mean ◽  
Complications Rate ◽  
Relevant Variation

Abstract INTRODUCTION The pandemic caused by the SARS-Cov-2 coronavirus has generated unprecedented pressure on healthcare systems. Higher mortality rates have been reported in elderly patients. Those with a hip fracture are especially vulnerable. MATERIAL AND METHODS Retrospective study in which we analyzed the management and associated perioperative complications rate in patients aged over 65 years who attended a tertiary hospital in Spain with hip fracture during the COVID-19 first alarm status decree . We compared the results with a cohort of similar patients treated during the same period in 2019. RESULTS A total of 102 hip fractures were recorded in 2019, with a mean age of 85 years. 87.5% were treated surgically in our hospital, with mean waiting time of 4.6 days and mean stay of 11.3 days. In 2020, 107 hip fractures were recorded, with a mean age of 86 years. A total of 74.6% underwent surgery in our center, with a mean waiting time of 2.8 days and a mean hospital stay of 10.9 days. The rate of major complications and exitus was 8.9% and 6.7% respectively in 2019, and 9.4% and 7.8% in 2020. CONCLUSIONS The number of hip fractures increased despite the declaration of the state of alarm in comparison with the decrease in the rest of the trauma emergencies. During this period the mean waiting time for surgery was shorter. There was no relevant variation in the demographic characteristics of the patients, nor in the rate of complications and reported exitus.

scholarly journals STMO-07 Adverse events related to the glioblastoma surgery and their perioperative management in our hospital

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii10-ii10
Author(s):  
Hideki Kashiwagi ◽  
Shinji Kawabata ◽  
Seigo Kimura ◽  
Ryokichi Yagi ◽  
Naokado Ikeda ◽  
...  
Keyword(s):  
Adverse Events ◽  
Venous Thrombosis ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Epileptic Seizures ◽  
Residual Tumor ◽  
Complete Removal ◽  
Tumor Localization ◽  
Vein Thrombosis ◽  
Before And After

Abstract Background: The standard treatment for glioblastoma is surgical resection following chemoradiation therapy. The rate of removal or the amount of residual tumor has some impact on the prognosis of patients with glioblastoma, but the highly invasive nature of this tumor makes complete removal limited to the contrast-enhanced lesions difficult due to its localization. Furthermore, when postoperative seizures and venous thrombosis are included in surgery-related complications, these perioperative adverse events can cause delays in the initiation of chemoradiotherapy and delay the return to work and home, such as prolonged hospitalization and rehabilitation time. Methods: We retrospectively reviewed the perioperative status of the recent 50 consecutive cases with histologically confirmed as glioblastoma at our hospital, the patient background, tumor localization, and perioperative treatment, and so on. Results: The major perioperative complications were ischemic or hemorrhagic complications, epileptic seizures, venous thrombosis, and pneumonia; CTCAE grade 2 or higher, grade 3 or higher, and grade 4 occurred in about 40%, 20%, and 10%, respectively, with some patients having multiple complications. Discussion: Although there was a tendency for ischemic changes around the cavity of the resection as the resection rate increased, most cases were asymptomatic and it seemed to be acceptable if residual brain function could be preserved. Residual tumors tended to show hemorrhagic changes and epileptic seizures because this is thought to be that the tumor was deliberately left in place to preserve function, based on the localization of the tumor. Postoperative FDP levels were useful in predicting the development of deep vein thrombosis and pulmonary artery thromboembolism. Conclusion: Because glioblastoma has short survival time and patient PS before and after surgery varies greatly depending on tumor localization, it is important to consider risk-benefit strategies for each case and to establish a scheme for a seamless transition from perioperative management to the introduction of postoperative therapy and maintenance therapy.

scholarly journals A Study on the outcome of surgical management of Unstable Intertrochanteric Fractures in the geriatric population by various modalities

2020 ◽  
Vol 8 (1) ◽  
pp. 43-47
Author(s):  
Ram Reddy V ◽  
Mohd Inayatulla Khan
Keyword(s):  
Surgical Management ◽  
Surgical Intervention ◽  
Operative Management ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Unique Challenge ◽  
Mortality And Morbidity ◽  
Cemented Bipolar Hemiarthroplasty

Background: Unstable hip fractures in elderly patients a unique challenge for orthopedic surgeons. Most of the cases are to be managed by surgical intervention. The problems of old age include the presence of osteoporosis, pre-existing arthritis, the overall health of the patient. We in the present study tried to evaluate the functional outcome of surgical management of unstable intertrochanteric fractures by various methods and study the effectiveness and complications of the operative management of unstable fractures. Methods: This cross-sectional study was carried out in the Department of Orthopedics, Prathima Institute of Medical Sciences, Nagunur, Karimnagar. All patients with unstable intertrochanteric fractures with age > 65 years who are treated by the surgical intervention were included in the study. All the patients were operated in Spinal anesthesia and The standard surgical procedures were followed for different modalities like DHS, PFN, Enders Nail’s and cemented bipolar hemiarthroplasty was done. Results: Out of n=50 patients n=28(56%) were female and n=22(44%) were males. The average duration of hospital stay was 14 days, with a range of 10-25 days. The mean blood loss in cemented bipolar hemiarthroplasty was 300 ml, PFN 100 ml, DHS was 250ml, and Ender’s Nail was 50ml. In our study of Bipolar hemiarthroplasty out of n=9 patients n=3 (33.34%) had excellent, n=5(55.56%) good outcome, n=1(11.12%) had fair outcomes respectively. Out of n=9 patients of PFN n=4 (44.44 %) of excellent, good n=4(44.44%), fair n=1 (11.12%) patient and no poor results. Out of n=25 patients of DHS n=20 (80%) patients are excellent to good results, n=3(12%) patient had fair and n=2 (8%) patients had poor results. Out of 7 patients of Ender’s nails n=2(28.573) had excellent and n=3(42.85%) had good and n=1(14.28%) fair, n=1(14.28) had poor results. Conclusion: Intertrochanteric Fractures in the geriatric population are a unique challenge it requires early operative management which will reduce both mortality and morbidity. Early mobilization following operative treatment will reduce the risks associated with prolonged bed rest in geriatric patients. Since failure rate is still high in unstable intertrochanteric fractures selection of proper implants is important for the ultimate success of the treatment.

scholarly journals Breakage of a Third Generation Gamma Nail: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Takashi Iwakura ◽  
Takahiro Niikura ◽  
Sang Yang Lee ◽  
Yoshitada Sakai ◽  
Kotaro Nishida ◽  
...  
Keyword(s):  
Rare Complication ◽  
Trochanteric Fracture ◽  
High Strength ◽  
The Elderly ◽  
Gamma Nail ◽  
Bipolar Hemiarthroplasty ◽  
Third Generation ◽  
Trochanteric Fractures ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Fractures Of The Femur

The use of intramedullary nails to treat trochanteric fractures of the femur has increased with the increasing size of the elderly population. The third generation Gamma nail is currently one of the most popular devices for the treatment of trochanteric fractures. Nail breakage is a rare complication, possibly resulting from fatigue fracture of the implant. We present the first reported case of breakage of a third generation Gamma nail that was not used to treat a pathological fracture. An 83-year-old woman with an unstable trochanteric fracture of the femur was treated using a third generation Gamma nail. She was referred to our hospital 14 months postoperatively with nail breakage at the opening for the lag screw. The breakage was secondary to nonunion, which was thought to be mainly due to insufficient reduction of the fracture. The broken nail was removed, and the patient underwent cemented bipolar hemiarthroplasty. At followup 18 months later, she was mobile with a walker and asymptomatic with no complications. This case shows that inadequate operation such as insufficient reduction of the trochanteric fracture may result in nonunion and implant breakage, even when using a high-strength, well-designed implant.

scholarly journals 0727 Study Onthe Effect Of Obstructive Sleep Apnea-hypopnea Syndrome Onperioperative Management Inendoscopic Sinussurgerypatients

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A277-A277
Author(s):  
Z Xiaojun ◽  
W Chan ◽  
W Hao ◽  
F Fang ◽  
X Wei
Keyword(s):  
Coronary Heart Disease ◽  
Obstructive Sleep Apnea ◽  
High Risk ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Sinus Surgery ◽  
Respiratory Complications ◽  
Municipal Administration ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome

Abstract Introduction To determine the frequency of undiagnosed OSA patients in patients received endoscopic sinus surgery (ESS) and to investigate the effect of OSA on the perioperative management in those patients. Methods 308 patients undergoing ESS from 2017-2019 were enrolled. The patients were divided into two groups according to whether OSA was combined. STOP-Bang questionnaire scoring system was used to classify patients into high risk and low risk for OSA. The differences between perioperative management and complications between the two groups were compared. Results 308 consecutive cases were included, 46 cases (14.9%) combined with OSA and 108 cases (35.0%) were at high risk of OSA. OSA patients have higher morbidity of hypertension (OR, 2.05; CI, 1.07-3.92; P=0.03), hyperlipidemia (OR, 2.19; CI, 1.06- 4.51; P=0.03), longer hospitalization time(7.0±2.7 vs. 5.4±3.6, P≤0.01) and higher incidence of intubation difficulties (OR, 3.74; CI,1.39-10.1; P=0.01). Patients at high risk of OSA also had increased rates of hypertension, hyperlipidemia, coronary heart disease and post-operative cardiovascular and respiratory complications. Conclusion OSA or high scores of STOP-Bang are associated with increased perioperative complications in ESS patients. Preoperative OSA screening should be strengthened to improve the safety and prognosis of ESS surgery. Support National Natural Science Foundation of China under Grant [number 81670903]; and Beijing Municipal Administration of Hospitals Ascent Plan under Grant [number DFL20150602]

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