scholarly journals Survey of the Outcome of Femoral Head Prosthesis Replacement of Unipolar Type for Intracapsular Femoral Neck Fracture in Elderly Patients.

1995 ◽  
Vol 44 (1) ◽  
pp. 235-241
Author(s):  
Yukihiko Tsutsumi ◽  
Tatsuo Kutsuna ◽  
Kazuo Konishi ◽  
Toshimitsu Koga ◽  
Ai Umemura ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Prosthesis Replacement ◽  
Neck Fracture ◽  
Intracapsular Femoral Neck Fracture

Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

2008 ◽  
Vol 149 (11) ◽  
pp. 493-503 ◽  
Author(s):  
Andor Sebestyén ◽  
Imre Boncz ◽  
Ferenc Tóth ◽  
Márta Péntek ◽  
József Nyárády ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

scholarly journals Intra-Articular Tranexamic Acid Injection During the Hip Hemi-Arthroplasty in Elderly Patients: A Retrospective Study

2018 ◽  
Vol 9 ◽  
pp. 215145931880385 ◽  
Author(s):  
Wei Liu ◽  
Huangdong Hui ◽  
Yunhai Zhang ◽  
Weilong Lin ◽  
Yongqian Fan
Keyword(s):  
Logistic Regression ◽  
Femoral Neck ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Femoral Neck Fracture ◽  
Mortality Rates ◽  
Transfusion Rate ◽  
Neck Fracture ◽  
Hemi Arthroplasty

Introduction: The objective was to evaluate the safety and efficacy of intra-articular injection of tranexamic acid (TXA) in patients between 80 and 100 years of age with femoral neck fracture undergoing hip hemi-arthroplasty (HA). Material and Methods: We conducted a retrospective review to assess perioperative blood loss and transfusion rate after intra-articular injection of TXA during HA. This was a single-center, retrospective, single-surgeon, and standard care cohort study covering the period between January and December 2016. One hundred three consecutive patients undergoing HA under spinal or general anesthesia were included. Fifty-four and 49 patients received and did not receive intra-articular injection of TXA during the HA, respectively. After closing the capsule, 50 mL of a TXA solution at a concentration of 1 g/100 mL of saline was injected into joint capsule. We compared the following outcomes: preoperative hemoglobin (HB) level, postoperative day 1 HB level, postoperative day 3 HB level, the net reduction of HB level by postoperative day 3, transfusion rate, and 30- and 90-day postoperative mortality rates. In addition, we use logistic regression to analyze the factors affecting the transfusion rate. Result: Day 3 postoperative HB level and the net reduction in HB level within 3 days following surgery were 93.22 ± 11.70 g/L and 25.98 ± 6.29 g/L in TXA group, respectively, while were 87.10 ± 10.52 g/L and 35.44±8.61 g/L in no-TXA group. Transfusion rate was 9% (5/54) in TXA group and 24% (12/49) in no-TXA group, respectively. The differences were statistically significant between the both groups. Logistic regression indicated that the topical administration of TXA would reduce the risk for transfusion, while in male diabetes mellitus would increase the risk. There were no significant differences in the deep venous thrombosis, pulmonary embolism, and mortality rates of 30 and 90 days postoperatively ( P > .05). Discussion: Because of lower systemic absorption and a higher concentration in the wound, topical use of TXA is safer for elderly patients who may have renal or liver dysfunction. TXA at therapeutic concentration does not affect platelet count, platelet aggregation, or coagulation parameters, and is of value in elderly patients who take antiplatelet drug for secondary prevention of cardiovascular diseases. Conclusion: For patients between 80 and 100 years of age with femoral neck fracture undergoing HA, intra-articular injection of TXA may reduce the perioperative blood loss and transfusion rate without increasing risk of thrombosis.

scholarly journals Re-Recognition of Garden Index as a Criterion for Evaluating the Quality of Femoral Neck Fracture Reduction: An Imaging Study Based on Cadaver Specimens

2021 ◽  
Author(s):  
Leyi Cai ◽  
Wenjie Li ◽  
Wenhao Zheng ◽  
Jianshun Wang ◽  
Xiaoshan Guo ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Kirschner Wire ◽  
Imaging Study ◽  
Lateral View ◽  
Healthy Human ◽  
Rotational Displacement ◽  
Significant Difference ◽  
Neck Fracture

Abstract ObjectiveTo investigate whether the Garden index can determine the rotational displacement of femoral neck fracture. MethodsTen healthy human femoral specimens were obtained. A 2.0 mm diameter Kirschner-wire was placed in the center of the femoral head. The osteotomy was perpendicular in the middle of the femoral neck. The distal osteotomy surface was indicated the angle of rotation (pronation and supination to 90°, every 10° was an interval). The X-ray of anterior-posterior and lateral view was taken at different angles according to the mark. The Garden index and other relevant data were analyzed with the PCAS system. Meanwhile, the change of the area of the femoral head fovea at different rotation angles was observed. ResultsThere was no significant difference in the Garden index in 0~30° at pronation and supination position (P>0.05). In range of 40°~90°, there was a statistical difference in the Garden index (P<0.05). With the increase of the pronation angle, the area of the femoral head fovea is gradually reduced; as the angle of the supination increases, the area of the femoral head fovea is gradually increased. ConclusionThe Garden Index cannot accurately determine the rotational displacement of the femoral neck fracture during the pronation or supination range of 0~30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture.Level of EvidenceLevel V.

scholarly journals Serum albumin and fixation failure with cannulated hip screws in undisplaced intracapsular femoral neck fracture

2016 ◽  
Vol 98 (6) ◽  
pp. 376-379 ◽  
Author(s):  
O Riaz ◽  
R Arshad ◽  
S Nisar ◽  
R Vanker
Keyword(s):  
Femoral Neck ◽  
Serum Albumin ◽  
Femoral Neck Fracture ◽  
Femoral Neck Fractures ◽  
Fixation Failure ◽  
Non Union ◽  
Preoperative Serum ◽  
Neck Fracture ◽  
Posterior Tilt ◽  
Intracapsular Femoral Neck Fracture

Introduction Internal fixation of undisplaced intracapsular femoral neck fractures with cannulated hip screws is a widely accepted surgical technique, despite reported failure rates of 12%–19%. This study determined whether preoperative serum albumin levels are linked to fixation failure. Methods We retrospectively reviewed 251 consecutive undisplaced intracapsular femoral neck fracture patients treated with cannulated hip screws in a district general hospital. Preoperative albumin levels were measured, and the fixation technique, classification and posterior tilt on radiography assessed. Fixation failure was defined as a screw cut, avascular necrosis (AVN) or non-union. Results Of the patients, 185 were female and 66 male. The mean age was 77 years (range 60–101 years). Thirty seven (15%) patients had fixation failure: 10 (4%) due to AVN; 12 (5%) due to non-union; and 15 (6%) due to fixation collapse. Low serum albumin levels were significantly associated with failure (p=0.01), whereas gender (p=0.56), operated side (p=0.62), age (p=0.34) and screw configuration (p=0.42) were not. A posterior tilt angle greater than 20° on lateral radiography significantly predicted failure (p=0.002). Conclusions Preoperative serum albumin is an independent predictor of cannulated hip screw fixation failure in undisplaced femoral neck fractures. Nutritional status should therefore be considered when deciding between surgical fixation and arthroplasty to avoid the possibility of revision surgery, along with an increased risk of morbidity and mortality.

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