scholarly journals Can distal radius or vertebra fractures due to low-energy trauma be a harbinger of a hip fracture?

2018 ◽  
Vol 29 (2) ◽  
pp. 100-103 ◽  
Author(s):  
Hasan Hüseyin Bozkurt
Keyword(s):  
Hip Fracture ◽  
Distal Radius ◽  
Low Energy

scholarly journals Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO’s Package of Interventions for Rehabilitation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Francesca Gimigliano ◽  
◽  
Sara Liguori ◽  
Antimo Moretti ◽  
Giuseppe Toro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Hip Fracture ◽  
Distal Radius ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Adult Population ◽  
World Health ◽  
The World

Abstract Background The identification of existing rehabilitation interventions and related evidence represents a crucial step along the development of the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR). The methods for such identification have been developed by the WHO Rehabilitation Programme and Cochrane Rehabilitation under the guidance of the WHO’s Guideline Review Committee secretariat. The aim of this paper is to report on the results of the systematic search for clinical practice guidelines (CPGs) relevant to the rehabilitation of adults with fractures and to present the current state of evidence available from the identified CPGs. Methods This paper is part of the Best Evidence for Rehabilitation (be4rehab) series, developed according to the methodology presented in the World Health Organization’s (WHO) Package of Interventions for Rehabilitation (PIR) introductory paper. It is a systematic review of existing CPGs on fractures in adult population published from 2009 to 2019. Results We identified 23 relevant CPGs after title and abstract screening. According to inclusion/exclusion criteria, we selected 13 CPGs. After checking for quality, publication time, multiprofessionality, and comprehensiveness, we finally included five CPGs dealing with rehabilitative management of fractures in adult population, two CPGs addressing treatment of distal radius fracture and three the treatment of femoral/hip fracture. Conclusion The selected CPGs on management of distal radius and femoral/hip fracture include few recommendations regarding rehabilitation, with overall low to very low quality of evidence and weak/conditional strength of recommendation. Moreover, several gaps in specific rehabilitative topics occur. Further high-quality trials are required to upgrade the quality of the available evidence. Level of evidence Level 1.

scholarly journals Predictors of In-Hospital Ambulatory Status Following Low-Energy Hip Fracture Surgery

2019 ◽  
Vol 10 ◽  
pp. 215145931881482 ◽  
Author(s):  
Jordan C. Villa ◽  
Joseph Koressel ◽  
Jelle P. van der List ◽  
Matthew Cohn ◽  
David S. Wellman ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hip Fracture ◽  
Peptic Ulcer Disease ◽  
Median Time ◽  
Low Energy ◽  
Ulcer Disease ◽  
Time To Surgery ◽  
Ambulatory Status ◽  
Delayed Time

Introduction: Twenty-five percent to seventy-five percent of independent patients do not walk independently after hip fracture (HF), and many patients experience functional loss. Early rehabilitation of functional status is associated with better long-term outcomes; however, predictors of early ambulation after HF have not been well described. Purposes: To assess the impact of perioperative and patient-specific variables on in-hospital ambulatory status following low-energy HF surgery. Methods: This is a retrospective analysis of 463 geriatric patients who required HF surgery at a metropolitan level-1 trauma center. The outcomes were time to transfer (out of bed to chair) and time to walk. Results: Three hundred ninety-two (84.7%) patients were able to transfer after surgery with a median time of 43.8 hours (quartile range: 24.7-53.69 hours), while 244 (52.7%) patients were able to walk with a median time of 50.86 hours (quartile range: 40.72-74.56 hours). Preinjury ambulators with aids (hazard ratio [HR]: 0.70, confidence interval [CI]: 0.50-0.99), age >80 years (HR: 0.66, CI: 0.52-0.84), peptic ulcer disease (HR: 0.57, CI: 0.57-0.82), depression (HR: 0.66, CI: 0.49- 0.89), time to surgery >24 hours (HR: 0.77, CI: 0.61-0.98), and surgery on Friday (HR: 0.73, CI: 0.56-0.95) were associated with delayed time to transfer. Delayed time to walk was observed in patients over 80 years old (HR: 0.74, CI: 0.56-0.98), females (HR: 0.67, CI: 0.48-0.94), peptic ulcer disease (HR: 0.23, CI: 0.84-0.66), and depression (HR: 0.51, CI: 0.33-0.77). Conclusions: Operative predictors of delayed time to transfer were surgery on Friday and time to surgery >24 hours after admission. Depression is associated with delayed time to transfer and time to walk. These data suggest that is important to perform surgeries within 24 hours of admission identify deficiencies in care during the weekends, and create rehabilitation programs specific for patient with depression. Improving functional rehabilitation after surgery may facilitate faster patient discharge, decrease inpatient care costs, and better long-term functional outcomes.

Role of Depression in Outcomes of Low-Energy Distal Radius Fractures in Patients Older Than 55 Years

2016 ◽  
Vol 30 (5) ◽  
pp. 228-233 ◽  
Author(s):  
Jane C. Yeoh ◽  
Jeffrey M. Pike ◽  
Gerard P. Slobogean ◽  
Peter J. OʼBrien ◽  
Henry M. Broekhuyse ◽  
...  
Keyword(s):  
Distal Radius ◽  
Low Energy ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals SOSTOYaNIE MINERAL'NOY PLOTNOSTI KOSTNOY TKANI U ZhENShchIN, PERENESShIKh MALOTRAVMATIChNYE PERELOMY V VOZRASTE 50 LET I STARShE

2012 ◽  
Vol 15 (2) ◽  
pp. 9-12
Author(s):  
O V Dobrovol'skaya ◽  
N V Demin ◽  
N V Toroptsova
Keyword(s):  
Bone Mineral Density ◽  
Hip Fracture ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
High Frequency ◽  
Low Energy ◽  
Mineral Density ◽  
Wrist Fractures ◽  
History Of ◽  
The Mean

This study was aimed to evaluate the bone mineral density (BMD) in women at the age of 50 years and older with the his tory of fracture(s) after a low-energy trauma. For this purpose the osteodensitometry of three areas was performed in 173 women with different low-traumatic fractures. Osteoporosis and osteopenia were found in 77% and 21% of patients respectively. Osteoporosis at least in one of three areas was revealed in 80% of women with hip fracture, in 77% of women with wrist fractures, in 73% of patients with humeral fractures, in 86% women after vertebral fractures and in 62% of patients with ankle fractures. Moreover, in these subgroups the osteoporosis in two areas of three was found in 38%, 23%, 30%, 33% and 24% of cases respectively. Osteoporosis in all three areas was detected more frequently in women with wrist fractures (in 39% of cases). The high frequency of osteoporosis in women with the history of low-traumatic fractures argues the need of an adequate antiosteoporotic treatment without mandatory verification of the reduced BMD by the mean of the osteodensitometry.

Distal radius fracture with ipsilateral elbow dislocation: a rare but challenging injury

2021 ◽  
Author(s):  
Henrik Constantin Bäcker ◽  
Kathi Thiele ◽  
Chia H. Wu ◽  
Philipp Moroder ◽  
Ulrich Stoeckle ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Elbow Dislocation ◽  
High Energy ◽  
Low Energy ◽  
Distal Radius Fractures ◽  
Radius Fracture ◽  
Associated Injuries ◽  
Radius Fractures ◽  
High Energy Trauma

Abstract IntroductionDistal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. The aim of this study was to analyse the mechanism and level of injury, demographics, and associated injuries in distal radius fractures with ipsilateral elbow dislocations.Methods:Between 2012 and 2019, we searched our trauma database for distal radius fractures with ipsilateral elbow dislocations. All patients older than 18 years old were included. Data on demographics, mechanism of injury, level of energy, and subsequent treatments were collected. ResultsA total of 7 patients were identified. The mean age was 68.7 ± 13.3 years old and the left side was involved in 71.4% of cases. Females were affected in 85.7% (n=6/7) of cases. All suffered from low-energy mechanism without other orthopaedic injuries at a mean age of 71.5 ± 12.3 years old. The one male patient that was included suffered from high-energy trauma at 52 years of age. Most commonly, posterior elbow dislocations were observed (66.7%; n=4/6). Distal radius fracture patterns include two C2, two C3, and one case each of C1-type and B1-type fracture pattern in the low energy group. In the group of patients who sustained high energy trauma, associated injuries include a concomitant open elbow dislocation, an ulnar artery rupture and damage to the flexor digitorum superficialis muscle.ConclusionAlthough distal radius fracture with ipsilateral elbow dislocation is thought to be resulting from high energy injuries, this study shows that most patients were elderly females suffering from low energy mechanisms. If not suspected, this could be missed especially in the setting of altered mental status. Careful physical examination of one joint proximal and one joint distal to the presumed site of injury is recommended.

scholarly journals Predicting Discharge Location among Low-Energy Hip Fracture Patients Using the Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA)

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Sanjit R. Konda ◽  
Hesham Saleh ◽  
Ariana Lott ◽  
Kenneth A. Egol
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Discharge Planning ◽  
Risk Index ◽  
Low Energy ◽  
Minimal Risk ◽  
Middle Aged ◽  
Readmission Rates ◽  
Risk Patients ◽  
Discharge Location

Patterns of discharge location may be evident based on the “sickness” profile of the patient. This study sought to evaluate the ability of the STTGMA tool, a validated mortality risk index for middle-aged and geriatric trauma patients, to predict discharge location in a cohort of low-energy elderly hip fracture patients, with successful discharge planning measured by readmission rates. Low-energy hip fracture patients aged 55 years and older were prospectively followed throughout their hospitalization. On initial evaluation in the Emergency Department, each patient’s age, comorbidities, injury severity, and functional status were utilized to calculate a STTGMA score. Discharge location was recorded with the primary outcome measure of an unsuccessful discharge being readmission within 30 days. Patients were risk stratified into minimal-, low-, moderate-, and high-risk STTGMA cohorts. A p-value of <0.05 was considered significant for all statistical tests. 408 low-energy hip fractures were enrolled in the study with a mean age of 81.3±10.6 years. There were 214 (52.5%) intertrochanteric fractures, 167 (40.9%) femoral neck fractures, and 27 (6.6%) subtrochanteric femur fractures. There was no difference in readmission rates within STTGMA risk cohorts with respect to discharge location; however, among individual discharge locations there was significant variation in readmission rates when patients were risk stratified. Overall, STTGMA risk cohorts appeared to adequately risk-stratify readmission with 3.5% of minimal-risk patients experiencing readmission compared to 24.5% of moderate-risk patients. Specific cohorts deemed high-risk for readmission were adequately identified. The STTGMA tool allows for prediction of unfavorable discharge location in hip fracture patients. Based on observations made via the STTGMA tool, improvements in discharge planning can be undertaken to increase home discharge and to more closely track “high-risk” discharges to help prevent readmissions.

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