scholarly journals Bilateral Neck of Femur Fractures in a Bilateral Below-Knee Amputee: A Unique Case

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Hannah R. Lancer ◽  
Peter Smitham ◽  
Pinak Ray
Keyword(s):  
Hip Fracture ◽  
Daily Activities ◽  
General Anaesthetic ◽  
Unique Case ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Total Hip Replacements ◽  
Walking Aids ◽  
Hip Replacements

According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses.

scholarly journals Four or Twelve Months' Follow-Up in the Evaluation of Functional Outcome after Hip Fracture Surgery?

2005 ◽  
Vol 94 (1) ◽  
pp. 59-66 ◽  
Author(s):  
T. Heikkinen ◽  
P. Jalovaara
Keyword(s):  
Hip Fracture ◽  
Repeated Measures ◽  
The Elderly ◽  
Important Variable ◽  
Walking Ability ◽  
Hip Fracture Surgery ◽  
Age Related ◽  
Walking Aids ◽  
One Year

Background and Aims: As a rule, follow-up for at least one year is recommended for fracture studies. This is considered the shortest reliable interval. Still, in the case of hip fractures of the elderly, shorter follow-up might be more practical, since the life expectancy of these patients is often short. The aim of this study was to see if a short four months follow-up period would be acceptable in hip fracture surveys. Material and Methods: Information on 196 consecutive non-pathological hip fracture patients aged 50 years or over (mean 79 years) was collected using a standardised hip fracture audit concentrating on functional measurements at admission and at four and twelve months' follow-ups. Results: 167 patients were alive at four months and 152 and at one year. The patients who died between four and twelve months had poorer functional capacity in the four-month evaluation than those who survived one year. The analysis of repeated measures, including only the patients alive at the last follow-up, showed that residential status, use of walking aids and 6 out of 10 and ADL variables (bathing, toileting, shopping, household activities, doing laundry, banking) did not change significantly. Walking ability and the rest 4 ADL variables (dressing, eating, food preparation, use of transportation) improved and pain decreased. Conclusions: Due to high mortality and age-related deterioration of functioning, no steady state i.e. “final result” is ever reached after hip fracture in the elderly. Four-month follow-up is justified as the shortest possible period, because the socioeconomically most important variable, i.e. place of living, and most of the ADL functions do not change significantly after that.

Ten-Year Follow-up Study of Charnley and Charnley-Mueller Total Hip Replacements.

1992 ◽  
Vol 41 (2) ◽  
pp. 604-607
Author(s):  
Kiyotaka Okuyama ◽  
Kenichiro Shibata ◽  
Masahiro Kina ◽  
Shinji Tomari ◽  
Shinichi Motomatsu ◽  
...  
Keyword(s):  
Total Hip ◽  
Follow Up Study ◽  
Total Hip Replacements ◽  
Hip Replacements

The importance of perioperative optimisation to facilitate safe regional anaesthesia and their improved outcomes in fracture neck of femur patients

2021 ◽  
pp. 175045892110640
Author(s):  
Benjamin Thomas Vincent Gowers ◽  
Michael Sean Greenhalgh ◽  
Kathryn Dyson ◽  
Karthikeyan P Iyengar ◽  
Vijay K Jain ◽  
...  
Keyword(s):  
Hip Fracture ◽  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
General Anaesthetic ◽  
Secondary Outcome Measure ◽  
Neck Of Femur ◽  
One Year ◽  
To Receive

Background: Hip fractures are common presentations to orthopaedic departments, and their surgical management often results in blood transfusions. Compared with general anaesthesia, regional anaesthesia reduces the need for transfusions and mortality in the wider surgical population. Aims: In hip fracture patients, our primary outcome measure was to examine any relationship between anaesthetic modality and transfusion rates. The secondary outcome measure was to assess the relationship between anaesthetic modality and one-year mortality. Methods: A retrospective cohort study of 280 patients was carried out in 2017 and 2018. Data were collected from patient records, local transfusion laboratory and the national hip fracture database. Results: A total of 59.6% had regional and 40.4% general anaesthesia. Regional anaesthesia patients were younger with fewer comorbidities (p < .05). About 19.8% regional and 34.5% general anaesthesia patients received transfusions (odds ratio (OR) = 0.47, p < .05); 13.6% were taking anticoagulants and were less likely to receive a regional anaesthetic (31.6% versus 64%, OR = 0.26, p < .05). One-year mortality was 27% for regional and 37% for general anaesthetic patients (OR = 0.64, p = .09). Conclusion: Regional anaesthesia halved the risk of blood transfusion. Anticoagulated patients were 74% less likely to receive regional anaesthetics, but had no additional transfusion risk. With optimisation, a larger proportion of patients could have regional anaesthesia.

Analysis of the Factors that Predispose to Wear with a 32mm Femoral Head at 5–15 Year follow-up: Clinical and Radiographic Assessment of the Harris-Galante cup at 5–15 Year follow-up

2003 ◽  
Vol 13 (2) ◽  
pp. 65-73
Author(s):  
M. Katsimihas ◽  
G. Katsimihas ◽  
M.B Lee ◽  
I. D. Learmonth
Keyword(s):  
Wear Rate ◽  
Polyethylene Wear ◽  
Young Patients ◽  
Harris Hip Score ◽  
Linear Wear ◽  
Outer Diameter ◽  
Linear Wear Rate ◽  
Total Hip Replacements ◽  
Hip Replacements

The clinical and radiographic features of 109 consecutive hybrid total hip replacements performed between 1986 and 1992 in 96 patients were retrospectively reviewed. A cementless Harris-Galante (HGP1) cup and a 32mm monobloc straight Muller stem were used in all cases. At an average 10.11 (range 5 to 15) years following surgery, the excellent durability of fixation of the Harris-Galante cup has been demonstrated with only one cup (0.9%) revised for periacetabular osteolysis and aseptic loosening. The prevalence of polyethylene wear was 27.4%. The mean annual linear wear rate was 0.063mm (range 0.00–0.53mm). There was a significantly increased wear of polyethylene inserts with an outer diameter < 52mm (<10mm polyethylene thickness), (ANOVA Test). However, there was no association found between acetabular liner wear and the following factors: underlying diagnosis, Charnley grade, age, weight and sex of the patient. The Harris Hip Score ranged between 5 and 54 pre-operatively and the average HHS was more than 80 post-operatively with more than 70% of patients pain-free. A liner with a thickness of 10mm or greater may prove beneficial in the prevention and reduction of wear rate particularly in young patients. It is recommended that all patients with this cup design, in which a polyethylene insert that is less than 10mm thick is coupled with a 32mm head, should continue to be regularly followed up.

Do We Need to Follow up Primary Total Hip Replacements?

2009 ◽  
Vol 19 (2) ◽  
pp. 99-102 ◽  
Author(s):  
Cronan Kerin ◽  
G. Cheung ◽  
N. Graham ◽  
P. Cool
Keyword(s):  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements

Ceramic-on-ceramic versus ceramic-on-polyethylene bearings in total hip arthroplasty: Results of a multicenter prospective randomized study and update of modern ceramic total hip trials in the United States

2005 ◽  
Vol 15 (3) ◽  
pp. 129-135 ◽  
Author(s):  
B. Sonny Bal ◽  
T.J. Aleto ◽  
J.P. Garino ◽  
A. Toni ◽  
K.J. Hendricks
Keyword(s):  
Aseptic Loosening ◽  
Randomized Study ◽  
The United States ◽  
Control Group ◽  
Time Interval ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Ceramic On Ceramic

One reason why otherwise well-functioning total hip replacements have a finite service life is eventual aseptic loosening of the implants because of osteolysis induced by wear particles from the artificial bearing. Pain and osteolysis from wear debris can manifest even in the absence of aseptic loosening. Total hip replacements with ceramic-on-ceramic articulations have shown less wear both in vitro and in vivo. A randomized prospective clinical trial was conducted to compare the outcomes of ceramic-on-ceramic articulations to ceramic-on-polyethylene articulations. Two-year data are of interest because premature failures of ceramic femoral heads usually occur by this time interval. Of 500 patients enrolled in this trial, half received total hip replacements with alumina-on-alumina bearings, while the other half had ceramic-on-polyethylene bearings. At the two-year follow-up, 444 patients (217 study group and 227 control group) were available for review. The clinical and radiographic outcomes between the groups were comparable, and reflected the typical results of primary total hip replacements. No complications related to spontaneous failures of the ceramic bearings were observed at this early follow-up period. Further follow-up is needed to confirm these findings over the long-term, but the short-term safety of alumina ceramic bearings in hip replacements reported in other recent reports is further validated by our findings.

scholarly journals Predictors of direct home discharge following fractured neck of femur

2017 ◽  
Vol 99 (6) ◽  
pp. 444-451 ◽  
Author(s):  
O Salar ◽  
PN Baker ◽  
DP Forward ◽  
BJ Ollivere ◽  
N Weerasuriya ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Trauma Centre ◽  
Fractured Neck Of Femur ◽  
Neck Of Femur ◽  
Mental Test Score ◽  
Hip Fracture Surgery ◽  
Home Discharge ◽  
Walking Aids ◽  
Major Trauma Centre ◽  
Alternative Location

INTRODUCTION Direct home discharge (DHD) following hip fracture surgery represents a challenging proposition. The aim of this study was to identify factors influencing the discharge destination (home vs alternative location) for patients admitted from their own home with a fractured neck of femur. METHODS A retrospective cohort study of prospectively collected major trauma centre data was performed, identifying 10,044 consecutive hip fracture admissions between 2000 and 2012. RESULTS Two-thirds of the patients (n=6,742, 67%) were admitted from their own home. Half of these (n=3,509, 52%) returned directly to their own home while two-fifths (n=2,640, 39%) were discharged to an alternative location; 593 (9%) died. The following were identified as independent variables associated with a higher likelihood of DHD: younger patients, female sex, an abbreviated mental test score of 10, absence of certain co-morbidities, cohabiting, walking independently outdoors, no use of walking aids, no assistance required with basic activities of daily living and intracapsular fracture. CONCLUSIONS Identifying those at risk of being discharged to an alternative location following admission from home on the basis of identified preoperative indices could assist in streamlining the postoperative care phase. Pre-emptive action may help increase the numbers of patients discharged directly home and reduce the number requiring additional rehabilitation prior to discharge home with its associated socioeconomic effect.

scholarly journals Cancer risk after total hip replacements. A prospective study of 41,402 patients in the Norwegian Arthroplasty Register linked to the Cancer Registry of Norway

2020 ◽  
Author(s):  
Eva Dybvik ◽  
Ove Furnes ◽  
Leif I. Havelin ◽  
Sophie D. Fosså ◽  
Clement Trovik ◽  
...  
Keyword(s):  
General Population ◽  
Cancer Risk ◽  
Cancer Registry ◽  
Arthroplasty Register ◽  
Total Hip ◽  
Total Hip Replacements ◽  
Hip Replacements ◽  
Risk Of Cancer ◽  
Norwegian Arthroplasty Register

Abstract Background Concerns have been raised that implants used in total hip replacements (THR) could lead to a future increased cancer risk. Several different materials and metals are used in joint prosthesis, as well as different fixation techniques and types of articulation for the surface of the joint can lead to an increased escape of particles or ions into the human body. Methods Patients with THR registered in the Norwegian Arthroplasty Register during 1987-2009 were linked to the Cancer registry of Norway. Patients with THR due to osteoarthritis, under the age of 75 at time of surgery, were included. Standardized incidence ratios (SIR) were applied to compare cancer risk for THR patients to the general population. Types of THR were divided into cemented (both components), uncemented (both components), and hybrid (cemented femoral and uncemented acetabular component). To account for selection mechanisms, time dependent covariates were applied in Cox-regression, adjusting for cancer risk the first 10 years after surgery. The analyses were adjusted for age, gender, and if the patient had additional THR-surgery in the same or the opposite hip. The study is according to the STROBE guidelines.Results When comparing patients with THR to the general population in Norway we found no differences in the risk. The overall SIR for the THR-patients after 10 years of follow-up was 1.02 (95% CI: 0.97-1.07). For cemented THR, the SIR after 10 years of follow-up was 0.99 (95% CI: 0.94-1.05), while it was 1.16 (95% CI: 1.02-1.30) for uncemented THRs, and 1.12 (95% CI: 0.91-1.33) for hybrid THRs. Adjusted Cox analyses showed that patients with uncemented THRs had an elevated risk of cancer (hazard ratio: HR=1.24, 95% CI: 1.05-1.46, p=0.009) when compared to patients with cemented THRs after 10 years of follow-up. The risk for patients with hybrid THRs was not significantly increased (HR=1.07, 95% CI: 0.85-1.35, p=0.55) compared to patients with cemented THRs. Conclusions We found that receiving an uncemented THR was associated with a small increased risk of cancer, in particular prostate cancer for younger men.

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