Injury
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This study aims to assess the mortality associated with hip fracture at 5 years in a geriatric population, and evaluate the influence of age, cognitive state, mobility and residential status on long term survival after hip fracture. ⋯ These findings will allow for early recognition of those patients with an increased chance of long-term survival following hip fracture. Such patients may be suitable for surgical treatment, such as total hip replacement, which has a good long-term outcome.
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This study was designed to estimate trends in the number of proximal femoral fractures (PFFs), and consequent bed day requirements and financial implications for England until 2033. ⋯ The evaluation and implementation of cost-effective preventive and therapeutic strategies in the short term may help to ameliorate the future financial burden of PFF, and, more importantly, improve the outcome and quality of life for the elderly after fracture.
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After surgical treatment of osteoporotic hip fractures, complications such as implant cut-out are reported to be high and implant failure often is associated with poor bone quality. As augmentation is reported to enhance implant anchorage, the aim of our study was to investigate the effect of bone cement augmentation on the rotational stability and the pull-out resistance of the Proximal Femur Nail Antirotation™ (PFNa) blade. ⋯ Augmentation of femoral heads yielded a significantly superior rotational stability, as well as an enhanced pull-out resistance, compared to the non-augmented state. However, the higher the BMD of the specimens, the lower was the effect of augmentation on the rotational stability. Therefore, augmentation can be a good clinical tool to enhance implant anchorage in osteoporotic bone.
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Femoral neck fracture is one of the common clinical traumas, especially amongst elder patients. This study aims to test, compare and evaluate the bone-screw interface strengths, the fatigue strengths, and the stabilities of our newly designed expansive cannulated screw (ECS) and the common cannulated compression screw (CCS) in the fixation of femoral neck fracture, which is a summary of recent research. ⋯ The ECS shows better fixation performance than the currently and commonly used CCS; under certain circumstances, fixation with two ECSs can achieve the same effect as that with traditional three CCSs.
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Anti-platelet drugs are commonly used for primary and secondary prevention of thrombo-embolic events and following invasive coronary interventions. Their effect on surgery-related blood loss and perioperative complications is unclear, and the management of trauma patients treated by anti-platelets is controversial. The anti-platelet effect is over in nearly 10 days. Notably, delay of surgical intervention for hip fracture repair for >48 h has been reported to increase perioperative complications and mortality. ⋯ Patients receiving anti-platelet drugs can safely undergo hip fracture surgery without delay, regardless of greater perioperative blood loss and possible thrombo-embolic/postoperative bleeding events.