scholarly journals Indications and results of osteosynthesis for proximal humerus fragility fractures in elderly patients

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Luigi Murena ◽  
Gianluca Canton ◽  
Chiara Ratti ◽  
Bramir Hoxhaj ◽  
Gioia Giraldi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Full Text ◽  
Elderly Population ◽  
Proximal Humerus ◽  
Surgical Techniques ◽  
Fragility Fractures ◽  
The Elderly ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocols ◽  
Clinical Conditions

Proximal humerus fractures (PHF) are common injuries in the elderly population. Conservative treatment is indicated for undisplaced and stable fractures, which account for almost 80% of the cases. More complex fracture patterns might need surgery, with a wide variety of indication criteria and surgical techniques described in the literature. Surgical treatment should be reserved for patients in good clinical conditions, autonomous in daily living activities and able to adhere to postoperative rehabilitation protocols. In the elderly population with severe osteoporosis, cognitive impairment and clinical comorbidities, the risk of surgical failures is high. In these patients, the choice between surgical and conservative treatment, as well as for the type of procedure, is even more difficult, with no general consensus in the literature. Final indication is usually conditioned by surgeon’s experience and preference. Two independent reviewers (B.H and G.G) independently extracted studies on proximal humeral fractures. All selected studies were screened independently (B.H and G.G) based on title and abstract. Then the full text of any article that either judged potentially eligible was acquired and reviewed again. Any disagreement was resolved by discussing the full text manuscripts. Aim of the present paper is to review the literature about indications and results of osteosynthesis for proximal humerus fragility fractures in the elderly population.

The New Geriatric Syndromes

2019 ◽  
Vol 15 (1) ◽  
pp. 33-36
Author(s):  
Animesh Gupta ◽  
Soumya K. Inamadar ◽  
Ashish Goel
Keyword(s):  
Health Outcomes ◽  
Sleep Disorders ◽  
Elderly Population ◽  
Oropharyngeal Dysphagia ◽  
The Elderly ◽  
Present Review ◽  
Social Deficits ◽  
Geriatric Syndromes ◽  
Adverse Health Outcomes ◽  
Clinical Conditions

Geriatric syndromes consist of common clinical conditions affecting the elderly population. They lead to multiple, interacting medical and social deficits that increase the risk of adverse health outcomes, including dependence, institutionalization and also death. Research over the last few decades, in this area of medicine, has led to evolution of newer syndromes that pose a greater challenge to the physician. The present review aims to provide a synopsis of some of the newer syndromes like frailty, osteosarcopenia, sleep disorders and oropharyngeal dysphagia that have emerged in geriatric literature in recent times.

scholarly journals Proximal Humeral Fractures: A Review of Current Concepts

2013 ◽  
Vol 7 (1) ◽  
pp. 361-365 ◽  
Author(s):  
James C. Widnall ◽  
Sujay K. Dheerendra ◽  
Joby Jacob George Malal ◽  
Mohammed Waseem
Keyword(s):  
Elderly Population ◽  
Proximal Humerus ◽  
Treatment Options ◽  
The Elderly ◽  
Open Reduction Internal Fixation ◽  
Non Union ◽  
Majority Group ◽  
Medullary Nailing ◽  
Humerus Fractures ◽  
Arthroplasty Surgery

The majority of proximal humerus fractures are sustained via low energy falls in the elderly population. These patients can attain an acceptable level of function via non-operative treatment. There is yet to be a clear consensus on treatment options suitable for those that fall outside of this majority group. Open reduction internal fixation, intra medullary nailing and arthroplasty surgery have all been used to varying effects. Good results are achievable if complications such as mal-union, non-union and avascular necrosis can be avoided. This review aims to clarify the options available to the current day trauma surgeon.

Displaced fragility fractures of proximal humerus in elderly patients affected by severe comorbidities: percutaneous fixation and conservative treatment

2013 ◽  
Vol 25 (4) ◽  
pp. 447-452 ◽  
Author(s):  
Massimo Innocenti ◽  
Christian Carulli ◽  
Roberto Civinini ◽  
Fabrizio Matassi ◽  
Massimiliano Tani ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Proximal Humerus ◽  
Fragility Fractures ◽  
Percutaneous Fixation

scholarly journals Prevalence of Vertebral Fractures in CTPA’s in Adults Aged 75 and Older and Their Association with Subsequent Fractures and Mortality

Geriatrics ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. 56
Author(s):  
Llewelyn Jones ◽  
Sukhdev Singh ◽  
Chris Edwards ◽  
Nimit Goyal ◽  
Inder Singh
Keyword(s):  
Vertebral Fracture ◽  
Clinical Outcomes ◽  
Computerized Tomography ◽  
Fragility Fracture ◽  
Vertebral Fractures ◽  
Elderly Population ◽  
Fragility Fractures ◽  
The Elderly ◽  
Overall Mortality

Identifying vertebral fractures is prudent in the management of osteoporosis and the current literature suggests that less than one-third of incidental vertebral fractures are reported. The aim of this study is to determine the prevalence of reported and unreported vertebral fractures in computerized tomography pulmonary angiograms (CTPA) and their relevance to clinical outcomes. All acutely unwell patients aged 75 or older who underwent CTPAs were reviewed retrospectively. 179 CTPAs were reviewed to identify any unreported vertebral fractures. A total of 161 were included for further analysis. Of which, 14.3% (23/161) were reported to have a vertebral fracture, however, only 8.7% (14/161) of reports used the correct terminology of ‘fracture’. On subsequent review, an additional 19.3% (31/161) were noted to have vertebral fractures. Therefore, the overall prevalence of vertebral fractures was 33.5% (54/161). A total of 22.2% (12/54) of patients with a vertebral fracture on CTPA sustained a new fragility fracture during the follow-up period (4.5 years). In comparison, a significantly lower 10.3% (11/107) of patients without a vertebral fracture developed a subsequent fragility fracture during the same period (p = 0.04). Overall mortality during the follow-up period was significantly higher for patients with vertebral fractures (68.5%, 37/54) as compared to those without (45.8%, 49/107, p = 0.006). Vertebral fractures within the elderly population are underreported on CTPAs. The significance of detecting incidental vertebral fractures is clear given the increased rates of subsequent fractures and mortality. Radiologists and physicians alike must be made aware of the importance of identifying and treating incidental, vertebral fragility fractures.

Extracranial-Intracranial Bypass in the Elderly

Neurosurgery ◽  
1981 ◽  
Vol 8 (5) ◽  
pp. 517-519 ◽  
Author(s):  
Robert Levinthal
Keyword(s):  
Elderly Population ◽  
Neurological Complication ◽  
Surgical Techniques ◽  
The Elderly ◽  
Intracerebral Hematoma ◽  
Cerebrovascular Insufficiency ◽  
Elderly Individuals ◽  
The Individual ◽  
Symptoms And Signs ◽  
Temporal Middle

Abstract The symptoms and signs of cerebrovascular insufficiency occur more frequently in the elderly population. It has often been assumed that individuals over 65 years of age are poor surgical candidates and that, therefore, prophylactic procedures should be withheld. The author reviews his experience with 25 elderly patients who had evidence of cerebrovascular insufficiency and lesions that were inaccessible to standard extracranial vascular surgical techniques. In this series, there were no deaths and there was only one neurological complication, which was a hypertensive hematoma that occurred during the immediate postoperative period. The only patient whose postoperative hospitalization was longer than 7 days was the individual who had the intracerebral hematoma. All patients with superficial temporal-middle cerebral artery anastomoses underwent angiography immediately after operation, and all of these bypass grafts were found to be patent. Extracranial-intracranial bypass grafting seems to be well-tolerated by elderly individuals, with minimal morbidity and mortality.

Validity and Reliability of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

GeroPsych ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 145-151
Author(s):  
Mahshid Foroughan ◽  
Zahra Jafari ◽  
Ida Ghaemmagham Farahani ◽  
Vahid Rashedi
Keyword(s):  
Psychometric Properties ◽  
Elderly Population ◽  
Formal Education ◽  
The Elderly ◽  
Cognitive State ◽  
Validity And Reliability ◽  
Internal Reliability ◽  
Dsm Iv ◽  
Test Retest Reliability ◽  
Farsi Version

Abstract. This study examines the psychometric properties of the IQCODE and its applicability in the Iranian elderly population. A group of 95 elderly patients with at least 4 years of formal education who fulfilled the criteria of DSM-IV-TR for dementia were examined by the MMSE and the AMTs. The Farsi version of the IQCODE was subsequently administered to their primary caregivers. Results showed a significant correlation ( p = .01) between the score of the questionnaire and the results of the MMSE ( r = −0.647) and AMTs ( r = −0.641). A high internal reliability of the questionnaire was confirmed by Cronbach’s alpha coefficient (α = 0.927) and test-retest reliability by correlation coefficient ( r = 0.81). This study found that the IQCODE has acceptable psychometric properties and can be used for evaluating the cognitive state in the elderly population of Iran.

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