For older adults with intracapsular hip fracture, how does internal fixation with screws and pins compare with use of a fixed angle plate?

2021 ◽  
Author(s):  
Jane Burch ◽  
Jaimo Ahn
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Internal Fixation ◽  
Fixed Angle ◽  
Intracapsular Hip Fracture ◽  
With Screws

scholarly journals Application of 3D printing and framework internal fixation technology for high complex rib fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuetao Zhou ◽  
Dongsheng Zhang ◽  
Zexin Xie ◽  
Yang Yang ◽  
Menghui Chen ◽  
...  
Keyword(s):  
3D Printing ◽  
Internal Fixation ◽  
Locking Plate ◽  
Rating Scale ◽  
Preoperative Planning ◽  
Numerical Rating Scale ◽  
Chest Ct ◽  
Rib Fractures ◽  
X Rays ◽  
With Screws

Abstract Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

scholarly journals Characteristics and Outcomes of Hip Fracture Patients Hospitalized in an Orthogeriatric Unit Versus an Orthopedic Department: A Retrospective Cohort Study

2021 ◽  
Vol 12 ◽  
pp. 215145932098629 ◽  
Author(s):  
Yulia Bugaevsky ◽  
Yochai Levy ◽  
Avital Hershkovitz ◽  
Irena Ocheretny ◽  
Adaya Nissenholtz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Functional Improvement ◽  
Orthopedic Department ◽  
Successful Recovery

Introduction: Hip fractures are a significant health risk in older adults and a major cause of morbidity, functional decline and mortality. Our aim was to compare clinical outcomes of older patients hospitalized in an ortho-geriatric (OG) unit to those hospitalized in an orthopedic department (OD) for surgical treatment of a hip fracture. Methods: A retrospective cohort study of hip fractured patients hospitalized between 2015-2016 in a single tertiary university-affiliated medical center. Included were patients aged 65 and older who had undergone hip fracture surgery and were admitted to either a geriatric or orthopedic ward. Results: 441 patients met the inclusion criteria (195 in the OG unit, 246 in the OD); 257 were transferred to an affiliated geriatric center hospital (107 from the OG unit and 127 from the OD) for rehabilitation. Patients in the OG unit were older, more cognitively and functionally impaired and with more comorbidities. The 1-year mortality rate was significantly lower in the OD group (OR 0.32, CI 95% 0.19-0.53, p < 0.001), however, after propensity matching, the 30-day and 1 year mortality rates were similar in both groups. No difference was found in the rehabilitation length of stay between the groups. The functional independence measure improvement was similar in both groups, with a non-significant trend toward better functional improvement among OG unit patients. Conclusions: Despite the higher complexity of patients, worse baseline functional capacity in the OG unit, improvement after rehabilitation was similar in both groups. These results demonstrate the advantages of the OG unit in treating and stabilizing frail older adults, thus maximizing their chances for a successful recovery after hip fractures. Level of Evidence: Level IV

scholarly journals Can Adding BMP2 Improve Outcomes in Patients Undergoing the SUPERhip Procedure?

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 495
Author(s):  
Dror Paley ◽  
Claire E. Shannon ◽  
Monica Nogueira ◽  
Catharina Chiari ◽  
Matthew Harris
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Varus Deformity ◽  
Drill Hole ◽  
Late Complications ◽  
Coxa Vara ◽  
Fixed Angle ◽  
Extremity Reconstruction ◽  
Delayed Ossification ◽  
Fixed Angle Device

Congenital femoral deficiency (CFD) Paley type 1b is characterized by severe bony deformity of the upper femur, extra-articular contractures of the hip, and, delayed ossification of the femoral neck and/or subtrochanteric region. The Systematic Utilitarian Procedure for Extremity Reconstruction of the hip (SUPERhip) procedure for the correction of CFD deformities was developed in 1997. Initially, a non-fixed angle device (rush rod) was used for fixation. Late complications of persistent delayed ossification and recurrent varus deformity occurred. In order to reduce and treat such complications, fixation with a fixed angle device and the off-label use of BMP2 to induce ossification of the un-ossified femoral neck were employed. The purpose of this study is to determine if the use of a fixed angle device, and, BMP2 inserted into a drill hole in the cartilage of the femoral neck, decreases the incidence of these late complications. We retrospectively reviewed 72 SUPERhip procedures performed for Paley type 1b CFD between 1997 and 2012. Due to recurrent varus or persistent delayed ossification of the femoral neck, 34 revision SUPERhip procedures were performed. In total, 106 SUPERhip procedures were studied. Sixty-eight SUPERhips were performed using internal fixation without BMP2, while 38 SUPERhips were performed with both internal fixation and the addition of BMP2. Forty-one were performed using non-fixed angle internal fixation while 65 had fixed angle internal fixation. Fixed angle devices significantly reduced the incidence of recurrent varus compared with non-fixed angle devices. Inserting BMP2 in the femoral neck significantly reduced the incidence of persistent delayed ossification. Using only a fixed angle device but no BMP2 did not reduce the incidence of delayed ossification. The combination of both a fixed angle device and BMP2 reduced the incidence of recurrent coxa vara and persistent delayed ossification of the femoral neck. The SUPERhip procedure corrects the pathoanatomy of the proximal femur in CFD Paley type 1b but is associated with a very high risk of recurrence of coxa vara and persistence of femoral neck delayed ossification, unless, a fixed angle internal fixation device is used to prevent recurrent coxa vara and BMP2 is used to induce ossification of the femoral neck.

The Association Between Sarcopenia and Postoperative Outcomes Among Older Adults With Hip Fracture: A Systematic Review

2021 ◽  
pp. 073346482110065
Author(s):  
Ming-Hsiu Chiang ◽  
Yi-Jie Kuo ◽  
Yu-Pin Chen
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Hip Fracture ◽  
Postoperative Mortality ◽  
Clinical Event ◽  
High Morbidity ◽  
Adverse Health Outcomes ◽  
Age Related ◽  
Study Selection ◽  
And Function

Hip fracture is a serious clinical event with high morbidity and mortality. Sarcopenia is characterized by age-related loss of muscle mass and function, leading to several adverse health outcomes. In this systematic review, no limitation criteria were used for study selection and 327 studies were identified in the initial search. Of these, 11 studies comprising a total of 2,314 patients were selected. The overall proportion of older adults with hip fracture having sarcopenia was 44%, with a disparity of approximately 10% between men and women. Most studies have indicated that older adults with sarcopenia had poorer postoperative functional recovery than those without sarcopenia; the association between sarcopenia and high postoperative mortality or long hospital stay was heterogeneous. Well-organized studies with longer follow-up periods are warranted.

scholarly journals Sernbo score predicts survival after intracapsular hip fracture in the elderly

2013 ◽  
Vol 95 (1) ◽  
pp. 29-33 ◽  
Author(s):  
EJC Dawe ◽  
E Lindisfarne ◽  
T Singh ◽  
I McFadyen ◽  
P Stott
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Risk Group ◽  
Characteristic Curve ◽  
Social Situation ◽  
High Risk Group ◽  
Low Risk ◽  
Risk Of Death ◽  
Intracapsular Hip Fracture ◽  
The Mean

Introduction The Sernbo score uses four factors (age, social situation, mobility and mental state) to divide patients into a high-risk and a low-risk group. This study sought to assess the use of the Sernbo score in predicting mortality after an intracapsular hip fracture. Methods A total of 259 patients with displaced intracapsular hip fractures were included in the study. Data from prospectively generated databases provided 22 descriptive variables for each patient. These included operative management, blood tests and co-mobidities. Multivariate analysis was used to identify significant predictors of mortality. Results The mean patient age was 85 years and the mean follow-up duration was 1.5 years. The one-year survival rate was 92% (±0.03) in the low-risk group and 65% (±0.046) in the high-risk group. Four variables predicted mortality: Sernbo score >15 (p=0.0023), blood creatinine (p=0.0026), ASA (American Society of Anaesthesiologists) grade >3 (p=0.0038) and non-operative treatment (p=0.0377). Receiver operating characteristic curve analysis showed the Sernbo score as the only predictor of 30-day mortality (area under curve 0.71 [0.65–0.76]). The score had a sensitivity of 92% and a specificity of 51% for prediction of death at 30 days. Conclusions The Sernbo score identifies patients at high risk of death in the 30 days following injury. This very simple score could be used to direct extra early multidisciplinary input to high-risk patients on admission with an intracapsular hip fracture.

Which factors are independent predictors of early recovery of mobility in the older adults’ population after hip fracture? A cohort prognostic study

2017 ◽  
Vol 138 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Mattia Morri ◽  
Cristiana Forni ◽  
Maura Marchioni ◽  
Elena Bonetti ◽  
Francesca Marseglia ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Early Recovery
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