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 Short term results of modular bipolar hemiarthroplasty for the treatment of neglected trochanteric femur fracture in the elderly

2019 ◽  
Vol 6 (1) ◽  
pp. 53
Author(s):  
Towseef Ahmad Bhat ◽  
Zameer Ali ◽  
Manik Sehgal
Keyword(s):  
Femoral Fractures ◽  
The Elderly ◽  
Clinical Results ◽  
Good Choice ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Postoperative Rehabilitation ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Fractures Of The Femur

<p class="abstract"><strong>Background:</strong> In rural India because of native practitioner culture people tend to neglect orthopaedic injuries and often present late to the hospitals. Bipolar hemiarthroplasty for neglected intertrochanteric fractures of the femur in the elderly yields good clinical results in terms of early postoperative ambulation. This will have a direct effect on the general condition and postoperative rehabilitation.</p><p class="abstract"><strong>Methods:</strong> Sixteen patients with proximal extracapsular femoral fractures presented average 10.4 weeks late from the day of injury, were treated with modular bipolar hemiarthroplasty. There were 11 men and 5 women, with mean age of 72.8 years (range: 65–83 years). Primary cemented bipolar hemiarthroplasty was performed using the Hardinge lateral approach in a lateral decubitus position. Harris hip score was used for the clinical evaluation of the patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> Clinically, the Harris hip score at the last follow-up ranged from 92 to 59, with a mean value of 81.7. Postoperative radiographs showed a good position in all patients. 1 patient developed complication during cementing and 1 case came with dislocation. No case of infection, acetabular erosion, periprostheic fracture or implant loosening was reported in this study.</p><p class="abstract"><strong>Conclusions:</strong> Primary cemented bipolar hemiarthroplasty is a good choice in elderly patients with neglected intertrochanteric fractures of the femur.</p>

scholarly journals STUDY OF SURGICAL MANAGEMENT OF INTESTINAL OBSTRUCTION FROM CENTRAL INDIA: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (3) ◽  
pp. 3070-3073
Author(s):  
Samadhan Patil
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Surgical Management ◽  
Central India ◽  
Signs And Symptoms ◽  
Tertiary Hospital ◽  
Acute Intestinal Obstruction ◽  
Postoperative Adhesions ◽  
Cross Sectional ◽  
Mortality And Morbidity

Intestinal obstruction is a common surgical emergency with high mortality and morbidity rates. About 15% of all emergency room visits for acute abdominal pain are due to intestinal obstruction. Acute intestinal obstruction may manifest in a variety of ways, from a relatively normal appearance with only minor abdominal pain and distension to a condition of hypovolemic or septic shock (or both) that necessitates an emergency procedure. In present study we aimed to evaluate surgical management of intestinal obstruction at our tertiary hospital. The current research included patients aged 21 to 80 who had an acute intestinal obstruction that was surgically treated. After initial resuscitation, patients with strong signs and symptoms of acute obstruction were treated with an appropriate surgical procedure. All of the information was recorded in a preformat and analysed using descriptive statistics. 144 patients had surgery for acute intestinal obstruction during the study period. 51 to 60 years old was the most common age group (26 %), followed by 41 to 50 years old (21 %). In a ratio of 2.8:1, male patients were more frequently affected than female patients. Previous abdominal surgery (56 %), diabetes (31 %), smoking (25 %), hypertension (24 %), and bronchial asthma/ COPD (15 %) were all found to be common comorbidities in this research. Postoperative adhesions (47 %), malignancy (15 %), obstructed hernia (11 %), and Koch's abdomen were the most common causes of intestinal obstruction in this report (8 %). Adhesiolysis (47 %), resection and anastomosis (22 %), diversion colostomy (13 %), and hernioplasty were the most common surgical procedures in this study (11 %). The most common post-operative complications were fever (15%) and wound infection (11%) respectively. The post-operative mortality rate was 13%. (9 patients). Complications such as septicaemia, peritonitis, and respiratory infection account for the majority of deaths. Intestinal obstruction is often caused by postoperative adhesions. Early operative procedures, in combination with clinical diagnosis and radiological findings, may enhance the outcome of acute intestinal obstruction.

scholarly journals To Study the Functional Outcome of Primary Cemented Bipolar Hemiarthroplasty in the Management of Unstable Inter-Trochanteric Fracture of Femur among Elderly

2017 ◽  
Vol 4 (1) ◽  
pp. 78
Author(s):  
Parth Vinod Agrawal ◽  
Nitin Wagh ◽  
Sandeep Pangavane
Keyword(s):  
Care Center ◽  
Weight Bearing ◽  
Tertiary Care ◽  
Trochanteric Fracture ◽  
Harris Hip Score ◽  
Full Weight Bearing ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Cemented Bipolar Hemiarthroplasty ◽  
A Prospective Study

Aims and Objectives: To evaluate the results with regard to function, to restoring proper limb length after surgery and to study the associated complications in intertrochanteric fractures treated by cemented bipolar hemiarthroplasty in elderly. Methodology: This is a prospective study of 25 cases of Intertrochanteric fractures admitted to a tertiary care center between August 2013 and November 2015 treated with Cemented Bipolar Hemiarthroplasty for intertrochanteric fractures. Cases were taken according to inclusion and exclusion criteria. Results: In our study of 25 cases, there were 14 male and 11 female patients with mean age of 72.8 years. 80% of the cases admitted were due to trivial trauma, 20% due to RTA with left side being more common side affected. According to OTA classification Type 31A2.2 fractures accounted for 60% of cases &amp; Type 31A2.3 accounted for 40 %.. Mean duration of hospital stay was 13.2 days and mean time of full weight bearing was 4.7days in our patients. Excellent was seen in 24% cases Fair to Good results were seen in 72% of cases in our study according to Harris Hip Score. Conclusion: From our study we conclude that Cemented Bipolar Hemiarthroplasty for intertrochanteric fractures in elderly reduced the complications of prolonged immobilisation, prolonged rehabilitation, marked residual deformities and need for revision surgeries. The procedure offered, faster mobilization, rapid return to pre injury level, improved the quality of life.

scholarly journals Anxiety and depression in the elderly due to COVID-19 pandemic: a pilot study

2021 ◽  
Vol 28 (1) ◽  
Author(s):  
Subhash Das ◽  
Priti Arun ◽  
Ravi Rohilla ◽  
Kantadorshi Parashar ◽  
Aratrika Roy
Keyword(s):  
Age Groups ◽  
Depression Scale ◽  
The Elderly ◽  
Anxiety And Depression ◽  
Morbidity Rate ◽  
Elderly Subjects ◽  
Unexpected Finding ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Mortality And Morbidity

Abstract Background The elderly are a vulnerable section of the population who are prone to physical, mental, social, and economic deprivation. The effect of COVID-19 had a worldwide impact on all age groups, with a particularly higher mortality and morbidity rate among the elderly population. The present study was undertaken to know about the psychological morbidity in the geriatric population during the period of the COVID-19 pandemic. The study was cross-sectional and was done through a telephonic survey. Eligible elderly subjects were contacted telephonically, and the Geriatric Anxiety Scale and the Geriatric Depression Scale were administered. To evaluate the functional ability of elderly subjects, the Everyday Abilities Scale for India (EASI) scale was administered. For the telephonic survey, verbal consent was sought. Results A total of 92 elderly subjects were included. Male outnumbered the females with a ratio of 1.8:1. Spouse and children were primary caregivers in 83.7% of the subjects. 90.2% were married, and 66.3% had earned a graduate/professional level of education. Chronic illness was present in 50% of subjects. The most common co-morbidities were hypertension (27.2%) and diabetes (21.7%). The proportion of elderly with anxiety and depression was 8.7% and 15.2% respectively. Conclusion The elderly showed lower levels of anxiety and depression. Higher resilience among the elderly and good family support may be the reasons for such an unexpected finding. However, more studies are required to validate the findings of the current study.

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