scholarly journals Cemented Bipolar Hemiarthroplasty for Fracture

2021 ◽  
pp. 170-178
Author(s):  
P. Sharajdeen ◽  
A. Sivakumar
Keyword(s):  
External Rotation ◽  
Management Strategies ◽  
Bed Rest ◽  
The Elderly ◽  
Pulmonary Complications ◽  
Coxa Vara ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Old Patients ◽  
Considerable Morbidity

Ashley Cooper recognized fractures in the proximal femur distal to the insertion of capsule. He noted that they invariably united without difficulty often with external rotation and shortening leading to coxa vara. Till the 1940s the standard treatment was reduction of the fracture and immobilization in plaster spica or in traction. The long period of immobility required for this treatment carried considerable morbidity, particularly in elderly patients. In addition to problems of prolonged bed rest, reports about various management strategies were not satisfactory. The justification for early rehabilitation in this group was accurately summed up by this quotation by Evans. '' The very old patients who sustain this injury tolerate pain and immobility badly; their mental state is often precarious and is quick to develop bed sores or pulmonary complications. We believe that they should be treated as surgical emergency and the older and more feebler the patient the more urgent is the need for the operation" The aim of this prospective and retrospective study is to analyse the short term follow up results of cemented bipolar hemi arthroplasty in neck of femur fracture and unstable intetrochanteric fractures of the elderly done in our institution.

scholarly journals Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

2020 ◽  
Vol 6 (2) ◽  
pp. 333
Author(s):  
Harpreet Singh ◽  
Tej S. Rudani ◽  
Malay P. Gandhi ◽  
Aliasgar J. Rampurwala
Keyword(s):  
Excellent Result ◽  
The Elderly ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Uncemented Hemiarthroplasty ◽  
Duration Of Surgery ◽  
The Mean ◽  
Neck Of Femur Fracture ◽  
Uncemented Group

<p class="abstract"><strong>Background:</strong> The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.</p><p class="abstract"><strong>Methods:</strong> A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. <strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.</p><p><strong>Conclusions:</strong> Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery &amp; complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study. </p>

scholarly journals Gamma 3 Long Nail for Complex Sub-Trochanteric Fractures: A Ten-Year Retrospective Study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Urso R ◽  
◽  
Milani L ◽  
Ortolan A ◽  
Martucci A ◽  
...  
Keyword(s):  
External Rotation ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
The Elderly ◽  
Gamma Nail ◽  
Trauma Centre ◽  
High Rate ◽  
Full Weight Bearing ◽  
Coxa Vara ◽  
X Rays

Cephalomedullary nailing is considered the treatment of choice for trochanteric and subtrochanteric femoral fractures. The aim of this study was to report postoperative outcomes of one of the widely used trochanteric nail device, the Gamma 3 long nail. We retrospectively assessed 405 patients treated with Gamma 3 long nail in a single Level One Trauma Centre between 2010 and 2018. We finally included 261 ambulant patients with 65 years or older, a lowenergy trauma and a closed trochanteric or subtrochanteric femoral fracture. Clinical outcomes were evaluated using the Hip Fracture Functional Recovery Score (FRS), while radiological complications and failures were assessed on postoperative x-rays. More than two-thirds of patients had completed fracture consolidation within 4 months after surgery. Immediate full weight bearing was allowed postoperatively in 64.0% of patients. We reported a mortality of 24.5% at one year postoperatively. The leading clinical postoperative complication was anemia (69.3%), followed by deep venous thrombosis (7.7%). Coxa vara was observed in 73 patients (28%), followed by malreduction in flexion-external rotation of the proximal femoral fragment (26.8%). No case of lag screw cutout was reported. Our study indicated that last generation of Long Gamma nail is a reliable implant for trochanteric and subtrochanteric femoral fractures in the elderly patients, leading to high rate of bone union and reduced incidence of related complications. An excellent fracture reduction and prevention of postoperative varus malalignment are the main factors that can avoid the major postoperative complications and failures after Gamma 3 long nailing.

scholarly journals Post-operative mortality and factors related to mortality after bipolar hemiarthroplasty in patients with femoral neck fractures

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2604-2608
Author(s):  
Prabhakaran A ◽  
Selvakumar P ◽  
Krishnagopal R ◽  
Anisha Rao
Keyword(s):  
Hip Fractures ◽  
Small Sample Size ◽  
The Elderly ◽  
Small Sample ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Medical College ◽  
Femur Fractures ◽  
Gandhi Medical College ◽  
Surgical Duration

Hip fractures are a common entity in the elderly. Hemiarthroplasty is a common treatment option for displaced neck of femur fractures and have been found to be successful in restoring mobility, reducing pain and improving quality of life following hip fractures in elderly. Many studies have reported that advanced age, male gender, long term stay in the intensive care unit, poor postoperative mobilization ability, a poor or dependent ADL score preoperatively, multiple comorbidities which result in a high ASA score have been associated with higher mortality. A retrospective study was done at the Department of Orthopaedics at Mahatma Gandhi Medical College and Research Institute, Pondicherry which included all patients who underwent hemiarthroplasty (both cemented and uncemented) from 2017-2020. The details of patients satisfying the inclusion criteria were obtained from the medical records department and were analysed by a single investigator. In case the subjects had not reviewed following surgeries, details were obtained by telephonic communication. In our study of 40 patients, mortality was observed in 4 patients which included 3 females and 1 male. It was also observed that mortality was high between the ages of 61-80 years, patients with multiple comorbidities and patients with high ASA scores. The hazard ratio was calculated for 3 parameters namely age, time to surgery and surgical duration and is 1.014, 0.842 and 0.984 respectively but this was not found to be statistically significant. This may due to the small sample size and retrospective nature of our study.

Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study

Injury ◽  
2015 ◽  
Vol 46 (10) ◽  
pp. 1988-1991 ◽  
Author(s):  
S.C. Jonas ◽  
R. Shah ◽  
N. Al-Hadithy ◽  
M.R. Norton ◽  
S.A. Sexton ◽  
...  
Keyword(s):  
Case Control Study ◽  
The Elderly ◽  
Case Control ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Control Study

scholarly journals Cemented Bipolar Hemiarthroplasty for Fracture Neck of Femur and Unstable Intertrochanteric Fractures - Prospective and Retrospective Study

2021 ◽  
pp. 263-266
Author(s):  
P. Sharajdeen
Keyword(s):  
Mortality Rate ◽  
Significant Risk ◽  
The Elderly ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Percent Mortality ◽  
Major Discrepancy ◽  
Minor Injuries ◽  
Cemented Bipolar Hemiarthroplasty ◽  
Better Than

Hip fractures in elderly patients are becoming a major social problem from various perspectives, including the progressive aging of global societies. The elderly have a high risk of hip fracture, even with minor injuries because of osteoporosis, while early surgical treatment may be difficult due to comorbidities and medication. In this study, significant risk factors were identified. Patients over age 70 had three times the mortality of younger patients. Greater than three pre-existing medical conditions is associated with a 25 percent mortality rate, more than twice that of healthier patients. Surgery performed on the first day of admission and beyond the fifth day was associated with a 34 percent mortality rate. Those patients operated in during days 2 through 5 had a 5.8 percent mortality rate. There was no failures related to inadequate stem or mechanical loosening. The tendency to dislocation can be clinically identifiable by major discrepancy in length, there was no failures related to inadequate stem or mechanical loosening. The tendency to dislocation can be clinically identifiable by major discrepancy in length and only 1 patient had shortening of about 2 cms post operatively which was slightly better than that of James et al (11%).

scholarly journals How to Treat Hepatocellular Carcinoma in Elderly Patients

2021 ◽  
Vol 14 (3) ◽  
pp. 233
Author(s):  
Piera Federico ◽  
Emilio Francesco Giunta ◽  
Annalisa Pappalardo ◽  
Andrea Tufo ◽  
Gianpaolo Marte ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Elderly Patients ◽  
Elderly Population ◽  
Primary Tumour ◽  
The Elderly ◽  
Chronic Liver Diseases ◽  
Old Patients ◽  
Choice Of Treatment ◽  
Definition Of ◽  
Optimal Treatment Strategy

Hepatocellular carcinoma (HCC) is the primary tumour of the liver with the greatest incidence, particularly in the elderly. Additionally, improvements in the treatments for chronic liver diseases have increased the number of elderly patients who might be affected by HCC. Little evidence exists regarding HCC in old patients, and the elderly are still underrepresented and undertreated in clinical trials. In fact, this population represents a complex subgroup of patients who are hard to manage, especially due to the presence of multiple comorbidities. Therefore, the choice of treatment is mainly decided by the physician in the clinical practice, who often tend not to treat elderly patients in order to avoid the possibility of adverse events, which may alter their unstable equilibrium. In this context, the clarification of the optimal treatment strategy for elderly patients affected by HCC has become an urgent necessity. The aim of this review is to provide an overview of the available data regarding the treatment of HCC in elderly patients, starting from the definition of “elderly” and the geriatric assessment and scales. We explain the possible treatment choices according to the Barcelona Clinic Liver Cancer (BCLC) scale and their feasibility in the elderly population.

scholarly journals P22 Are Elderly Patients at Increased Perioperative Morbidity and Mortality from Oesophagectomy for Oesophageal Cancer? A Systematic Mapping Review and Meta-Analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Rohan R Gujjuri ◽  
Muhammed Elhadi ◽  
Hamza Umar ◽  
Manjunath S Subramanya ◽  
Richard P T Evans ◽  
...  
Keyword(s):  
Elderly Population ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
The Elderly ◽  
Pulmonary Complications ◽  
Cardiac Complications ◽  
Anastomotic Leaks ◽  
Free Survival ◽  
Younger Patients ◽  
Disease Free

Abstract Introduction Oesophagectomy is being increasingly performed in an ageing population that is observing a concomitant growth in the life expectancy. However, the risks are poorly quantified, and this study aims to review current evidence to further quantify the postoperative of oesophagectomy in the elderly population compared to younger patients. Methods A systematic electronic search was conducted for studies reporting oesophagectomy in the elderly population. Meta-analysis was performed using random-effects modelling to compute odds ratios (OR) and 95% confidence intervals (CI). Primary outcome was overall complications and secondary outcomes included anastomotic leaks, cardiac complications, pulmonary complications, overall and disease-free survival. Meta-regression was performed to identify study-, hospital- and patient-level factors confounding study findings. Results This review included 37 eligible studies involving 61,723 patients. Increasing age was significantly associated with increased rates of overall complications (OR: 1.67, CI 95%: 1.42 – 1.97), cardiac complications (OR: 1.62, CI 95%: 1.10 – 2.40), pulmonary complications (OR: 1.44, CI 95%: 1.11 – 1.87) and decreased 5-year overall survival (OR: 1.36, CI 95%: 1.11 – 1.66) and 5-year disease-free survival (OR: 1.66, CI 95%: 1.40 – 1.97). Rates of anastomotic leaks showed no difference between elderly and younger patients (OR: 1.06, CI 95%: 0.71 – 1.59). Conclusion Postoperative outcomes such as overall complications, 5-year overall survival and disease-free survival appear to significantly worse in all age cut-offs in this meta-analysis. Sarcopenia and frailty act as better predictors of postoperative outcomes than chronological age. This study confirms the preconceived suspicions of increased risks in elderly patients following oesophagectomy and will aid future pre-operative counselling and informed consent.

HYPERTENSION IN ELDERLY:OUR CURRENT TRENDS

2021 ◽  
pp. 56-57
Author(s):  
Rohit Arora ◽  
D.K Sharma
Keyword(s):  
Blood Pressure ◽  
Elderly Patients ◽  
The Elderly ◽  
Common Disease ◽  
Old Patients ◽  
Current Trends ◽  
Increased Risk ◽  
Individualized Approach ◽  
Risk Of Falls ◽  
Optimal Target

Hypertension is a common disease in the elderly associated with signicant morbidity and mortality. Due to the complexity of this population, the optimal target of blood pressure (BP) control is still controversial. In this article, we conduct a literature review of trials published in English in the last 10 years which were specically designed to study the efcacy and safety of various BP targets in patients who are 70 years or older. Using these criteria, we found that the benets in the positive studies were demonstrated even with a minimal BPcontrol (systolic BP[SBP] <150 mmHg) and continued to be reported for a SBP<120 mmHg. On the other hand, keeping SBP<140 mmHg seemed to be safely achieved in elderly patients. Although the safety of lowering SBP to <120 mmHg is debated, Systolic Blood Pressure Intervention Trial study has shown no increased risk of falls, fractures, or kidney failure in elderly patients with SBP lower than this threshold. While the recent guidelines recommended to keep BP <130/80 mmHg in the elderly, more individualized approach should be considered to achieve this goal in order to avoid undesirable complications. Furthermore, further studies are required to evaluate BPtarget in very old patients or those with multiple comorbidities.

scholarly journals Managing Eating Disorders in Elderly with Dementia and the Ethical Considerations for Tube Feeding

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Quality Of Life ◽  
Eating Disorders ◽  
Management Strategies ◽  
Tube Feeding ◽  
The Elderly ◽  
Feeding Tube ◽  
Medical Complications ◽  
Ethical Considerations ◽  
Nutritional Needs

As dementia progresses, the elderly with dementia often have difficulties finishing their meals and weight loss is a common feature at this stage of their dementia journey. Eating disorders cause tremendous caregiver stress and burden. In considering provision of best care for this group of elderly, the hospital is probably not the best place and yet, they are frequently brought in to the hospital to seek help for fever, pneumonia, dislodged feeding tube, medical complications arising from poor feeding and dehydration. It is important to understand the aetiology of poor feeding among this group of patients and advise the patients and their family on the appropriate management strategies to improve the intake of food and to maximize their quality of life. At this stage of dementia, focusing on means to ensure nutritional needs are met may end up causing further harm and distress.

Sign in / Sign up

Export Citation Format

Share Document