AN OBSERVATIONAL STUDY OF COMPARISON BETWEEN TREATMENT OUTCOME OF DHS AND DCS FIXATION IN HIP FRACTURE AND ITS ASSOCIATED MEDICAL COMPLICATIONS

2021 ◽  
pp. 63-64
Author(s):  
Nilabh Kumar ◽  
Laljee Chaudhary ◽  
Debarshi Jana
Keyword(s):  
Treatment Outcome ◽  
Hip Fracture ◽  
Urinary Infection ◽  
The Elderly ◽  
Age Group ◽  
Common Complication ◽  
Trochanteric Fractures ◽  
Time Of Admission ◽  
Tremendous Impact

Background: Trochanteric fractures are devastating injuries that commonly affect the elderly and have a tremendous impact on the health care system and society in general. Fracture are often associated with varies complications.The purpose of our study was to compare treatment outcome of DHS and DCS xation in hip fracture and its associated complications. Material and methods: A total of 60 patients were selected for the study. Clinical and radiographic examinations were performed at the time of admission and postoperatively. Follow up was done at an interval of 6th month, and 12th month. Various complications reported were recorded. Result: Most common complication reported was urinary infection in our study. There was no signicant treatment outcome of two different groups. Conclusion: Over 90% of hip fracture occurs in older age group i.e. 65 years. With the increasing age increases the in complications has been noticed

scholarly journals Hip fractures among the elderly in Kyoto, Japan: a 10-year study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maki Asada ◽  
Motoyuki Horii ◽  
Kazuya Ikoma ◽  
Tsuyoshi Goto ◽  
Naoki Okubo ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Femoral Neck ◽  
Incidence Rate ◽  
Acute Care ◽  
Hip Fractures ◽  
Age Groups ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Age Group ◽  
Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

scholarly journals Mechanism of Unstable Inter-trochanteric Fractures in the Elderly

2020 ◽  
pp. 120-134
Author(s):  
S. Santhosh
Keyword(s):  
Femoral Fractures ◽  
Early Mobilization ◽  
The Elderly ◽  
Trochanteric Fractures ◽  
Non Union ◽  
Prospective Comparative Study ◽  
Hip Screw ◽  
Hemi Arthroplasty ◽  
Tremendous Impact

The aim of this prospective comparative study is to analyse the short term follow-up results of unstable inter-trochanteric fractures in the elderly treated with Bipolar hemi-arthroplasty and Dynamic hip screw fixation done in our institution from March 2017 to October 2018. Proximal femoral fractures in the elderly individuals have a tremendous impact on both the health care system and society. Upon treatment of inter-trochanteric factures with conservative management, it usually unites with a mal-union, non-union and with shortening, but the problem of non –union in trochanteric fractures has less incidence. Because of complications associated with prolonged recumbency and its associated morbidities. Primary hemiarthroplasty in these patients provides for adequate fixation and early mobilization. It alleviates pain and improves function. It also prevents post-operative complications such as pneumonia, lung atelectasis and pressure sores. From our clinical observation we would suggest that unstable intertrochanteric fractures in elderly result most frequently from accidental fall (52.5%), being the most common described mechanism of injury.

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.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

Unstable trochanteric Fracture Fixation with P.F.N. augmented by T.B.W.

2021 ◽  
Vol 8 (1) ◽  
pp. 39-42
Author(s):  
Dr. Vijay Patil ◽  
Dr. Pandurang Daule ◽  
Dr. Deepak Naikwade
Keyword(s):  
Femoral Head ◽  
Trochanteric Fracture ◽  
Bony Union ◽  
Age Group ◽  
Lateral Migration ◽  
Trochanteric Fractures ◽  
Screw Breakage ◽  
Hip Function ◽  
The Stability

Biomechanically Proximal Femoral Nail (PFN) is a better choice of implant. Still it is associated with screw breakage, cut out through femoral head,”Z” effect, reverse “Z” effect and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of post operative complication and failure rates in unstable trochanteric fracture. Methodology: We did study of 21 unstable trochanteric fractures from Jan 2016 to Nov .2020. 14 patients were males & 7 patients were females. Age group between 25 to 80 was included in this group. There were 15 A0 A2 (2.2, 2.3) and 6 were A0 A3 (3.1, 3.2, 3.3). All fractures were fixed with 25cm, 1350 PFN mainly 11 mm, 12mm in diameter augmented with one or two 16 gauge tension band wire, strengthening lateral trochanteric wall and holding either communiated   fragments or lesser trochanteric fracture. Results: The bone healing was observed in all cases with mean period of 16 weeks. Two patients developed complication of TBW breakage; one developed lateral migration of screws. Patients were followed till # union. At the end of follow up the Salvati and Wilson hip function was 30 (out of 40) in 80% patients. Conclusion: The stabilization of lateral trochanteric wall fracture and communicated fragments with additional one or two TBW increases the stability of construct enhancing bony union & better results.

scholarly journals Hip Fractures in the Elderly During the COVID-19 Pandemic: A Latin-American Perspective With a Minimum 90-Day Follow-Up

2021 ◽  
Vol 12 ◽  
pp. 215145932110245
Author(s):  
Tomas Zamora ◽  
Felipe Sandoval ◽  
Hugo Demandes ◽  
Javier Serrano ◽  
Javiera Gonzalez ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Latin American ◽  
Clinical Information ◽  
The Elderly ◽  
Older Age ◽  
Morbidity And Mortality ◽  
Level Of Evidence ◽  
Fragility Hip Fracture

Introduction: Hip fracture patients have been severely affected by the COVID-19 pandemic; however, the sub acute effects of a concomitant SARS-CoV-2 infection and the outcomes in highly exposed developing countries are still unknown. Our objective is to describe the morbidity and mortality of elderly patients admitted for a hip fracture during the COVID-19 pandemic in Chile, with a minimum 90-day follow-up. Also, to elucidate predictors for mortality and to compare mortality results with the pre-pandemic era. Material and Methods: Multicentric retrospective review of patients admitted for a fragility hip fracture in 3 hospitals during the COVID-19 pandemic, and during the same time in 2019. All clinical information and images were recorded, and patients were followed for a minimum of 90-days. Morbidity and mortality were the primary outcomes. Uni/multivariable models were performed to elucidate predictors for mortality utilizing the Weibull’s regression. Results: Three hundred ninety-one cases were included. From the 2020 cohort (162 patients), 24 (15%) had a concomitant SARS-CoV-2 infection. Fourteen patients (58%) tested positive after admission. The COVID-19(+) group had a higher risk of in-hospital, 30-day, and 90-day mortality (p < 0.001). They also had a prolonged hospital stay and presented with more complications and readmissions (p < 0.05). Only COVID-19(+) status and older age were independent predictors for mortality with a HR = 6.5 (p = < 0.001) and 1.09 (p = 0.001), respectively. The 2020 cohort had twice the risk of mortality with a HR = 2.04 (p = 0.002) compared to the 2019 cohort. However, comparing only the COVID-19 (-) patients, there was no difference in mortality risk, with a HR = 1.30 (p = 0.343). Discussion: The COVID-19 pandemic has significantly affected healthcare systems and elderly patients. Conclusions: Hip fracture patients with a concomitant SARS-CoV-2 virus infection were associated with increased morbidity and mortality throughout the first 3 months. COVID-19 status and older age were significant predictors for mortality. Efforts should be directed into nosocomial infection reduction and prompt surgical management. Level of evidence: Level III

scholarly journals Early osteoporosis diagnosis improves post-hip fracture outcome

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Lavranos ◽  
P P Manolopoulos ◽  
P Xenophontos ◽  
P Vogazianos ◽  
K Tsioutis ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Osteoporosis Treatment ◽  
The Elderly ◽  
University Hospital ◽  
High Rate ◽  
Osteoporosis Screening ◽  
Fracture Outcome ◽  
Overall Mortality

Abstract Background Hip fracture is associated with mortality and high rate of hospital re-admission after discharge. Osteoporosis screening and treatment have been shown to lower the risk of hip fractures. The aim of this study was to assess whether osteoporosis treatment also improves the post-hip fracture overall outcome. Methods All patients over the age of 65 that sustained a hip fracture at a tertiary University Hospital were approached to enroll in the study. The patients were informed of the context of the study, all queries were answered and an informed consent was signed by the patients in the presence of one of the investigators. The data were collected over an 8 month period from October 2017 to June 2018 and the cohort was followed up until February 2019. Recorded outcomes included mortality, re-admission and unscheduled hospital visit. Results The overall mortality rate of elderly patients after a hip fracture was 12.3% (n = 24) after a 6 month follow-up period. The overall event rate of elderly patients after a hip fracture was 29.7% (n = 58) after a 6 month follow-up period. Only 3% of patients were already on osteoporosis treatment. However, patients on treatment for osteoporosis had a favorable outcome with no deaths and significantly less overall events (p &lt; 0.0001). Conclusions Early osteoporosis screening and treatment in the elderly can not only prevent falls and fractures, but also improve outcome in case a hip fracture does occur. Key messages Osteoporosis treatment improves outcome after a hip fracture. Despite relevant guidance, osteoporosis screening in the elderly remains suboptimal.

scholarly journals Comparing the Camry dynamometer to the Jamar dynamometer for use in healthy Colombian adults

2019 ◽  
Vol 9 (2) ◽  
pp. 21-29
Author(s):  
Gustavo Alfonso Díaz Muñoz ◽  
Sandra Julieth Calvera Millán
Keyword(s):  
Grip Strength ◽  
Old Age ◽  
Population Level ◽  
The Elderly ◽  
Age Group ◽  
Cross Sectional ◽  
Hand Grip ◽  
Hand Dynamometer ◽  
Jamar Dynamometer

Objective: Hand grip strength can provide an objective index of general upper strength, but hand dynamometer has not been validated for use in Colombia. The objective was to determine the interchangeability between Camry electronic and Jamar hydraulic hand grip dynamometers in a population found on the campus of the Universidad Nacional de Colombia and the elderly living in a community. Methods: This was a cross-sectional concordance study on 18-88-year-old males and females. Data regarding their demographics, health, and anthropometric variables were collected/measured and the Lin concordance correlation coefficient (CCC) along with Bland-Altman plots were used for evaluating concordance regarding both devices. Results: One hundred and thirty-three subjects participated in this study (average age 47±20.74 years-old). Right hand (RH) grip strength was 32.15 ± 9.96 kg with the Jamar dynamometer and 29.95 ± 9.18 kg with the Camry device. It is worth highlighting that the Jamar instrument presents higher values than the Camry instrument (p <0.05). CCC was only significant at the population level and for the 40-59-year-old age group. Bland-Altman plots had narrow limits of agreement. Conclusion: We concluded that the Camry dynamometer could replace the Jamar dynamometer in the 40-59-year-old age group; furthermore, it would be appropriate for medical use in patient monitoring or follow-up due to the close values observed.

scholarly journals Is the BioNTech-Pfizer COVID-19 vaccination effective in elderly populations? Results from population data from Bavaria, Germany

2021 ◽  
Author(s):  
Delphina Gomes ◽  
Andreas Beyerlein ◽  
Katharina Katz ◽  
Gabriele Hoelscher ◽  
Uta Nennstiel ◽  
...  
Keyword(s):  
Sex Differences ◽  
Prospective Observational Study ◽  
Age Groups ◽  
Population Data ◽  
The Elderly ◽  
Elderly Persons ◽  
Age Group ◽  
German State ◽  
Elderly Populations

Background The effect of the BioNTech-Pfizer BNT162b2 vaccination in the elderly (>=80 years) could not be fully assessed in the BioNTech-Pfizer trial due to low numbers in this age group. We aimed to evaluate the effectiveness of the BioNTech-Pfizer (BNT162b2) vaccine to prevent SARS-CoV-2 infection and severe outcomes in octo- and novo-generians in a German state setting. Methods and Findings A prospective observational study of 708,187 persons aged >=80 years living in Bavaria, Germany, was conducted between Jan 9 to Apr 11, 2021. We assessed the vaccine efficacy (VE) for two doses of the BNT162b2 vaccine with respect to SARS-CoV-2 infection and related hospitalisations and mortality. Additionally, differences in VE by age groups >=80 to <=89 years and >=90 years were studied. Analyses were adjusted by sex. By the end of follow-up, 63.8% of the Bavarian population ≥80 years had received one dose, and 52.7% two doses, of the BNT162b2 vaccine. Two doses of the BNT162b2 vaccine lowered the proportion of SARS-CoV-2 infections and related outcomes, resulting in VE estimates of 68.3% (95% confidence interval (CI) 65.5%, 70.9%) for infection, 73.2% (95% CI 65.3%, 79.3%) for hospitalisation, and 80.1% (95% CI 80.0%, 89.0%) for mortality. Sex differences in the risk of COVID-19 outcomes observed among unvaccinated persons disappeared after two BNT162b2 vaccine doses. Overall, the BNT162b2 vaccine was equally efficacious in octo- and novo-genarians. Conclusions Two doses of BioNTech-Pfizers BNT162b2 vaccine is highly effective against COVID-19 outcomes in elderly persons.

Personality Disorder in the Elderly Depressed

1994 ◽  
Vol 39 (7) ◽  
pp. 392-398 ◽  
Author(s):  
Ruth G. Vine ◽  
Allan B. Steingart
Keyword(s):  
Social Support ◽  
Personality Disorder ◽  
Rating Scale ◽  
Affective State ◽  
The Elderly ◽  
Structured Interview ◽  
Day Hospital ◽  
Social Support Scale ◽  
Time Of Admission

The objectives of this study were to examine the association of personality disorder with outcome of depression in older patients (age ≥ 60) treated in a psychiatric day hospital for depression and to compare the clinical diagnosis of personality disorder at admission with the results of a semi-structured interview at follow-up. Sixty-four patients were followed up for a mean interval of 30 (13–49) months after admission to the psychiatric day hospital and the semi-structured interview, Social Support Scale, Life Events Inventory, Hamilton Depression Rating Scale and Mini-Mental State Examination administered by a psychiatrist blind to the details of the index admission. Forty-nine informants (a close friend or relative) were also interviewed using the semi-structured interview. Axis II diagnoses at the time of admission were determined from patient records. Personality disorder diagnoses were analysed according to DSM-III-R clusters. Twenty-one (33%) patients fulfilled criteria for personality disorder at admission and 23 (36%) at follow-up. There was strong agreement (k = 0.78) between patient and informant semi-structured interview results and moderate agreement (k = 0.41) between diagnosis at admission and at follow-up. Presence of a personality disorder, and in particular a cluster B personality disorder diagnosis was associated with chronic outcome of depression and with impaired social support. Personality is a significant factor in the outcome of depression in the elderly. It remains unclear whether current methods of assessment tap enduring characteristics, or manifestations of affective state.

Sign in / Sign up

Export Citation Format

Share Document