The Orthopedic clinics of North America
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Hip fractures represent a widespread morbidity among the geriatric population. In North America, more than 320,000 hip fractures are sustained annually, a number that is expected to increase dramatically as the population continues to age. ⋯ The co-occurrence of cognitive dysfunction and hip fracture is an important entity for orthopedic surgeons and other clinicians involved in hip fracture care to recognize. This article provides an overview of the currently available evidence regarding cognitive dysfunction, specifically dementia and delirium, in patients with hip fractures.
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As with most fractures associated with osteoporosis, the incidence of pelvic ring injuries in this population of patients is rising rapidly. Osteoporotic pelvic ring injuries are exceedingly different in their etiology, natural history, and treatment from the more recognizable patterns in young patients with high-energy pelvic ring injuries. Recognition of a potentially unstable fracture pattern, careful evaluation of the ambulatory and functional status of each patient before injury, and the potential pitfalls and benefits of operative versus nonoperative care are critical to the effective treatment.
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Ankle fractures are one of the most common injuries in the elderly and their incidence is anticipated to increase over the next 20 years. Appropriate management of ankle fractures in this population requires an understanding of the issues unique to the elderly. ⋯ Postoperative complications are higher in patients with diabetes and peripheral vascular disease, and in patients who smoke. This article reviews how to evaluate and treat ankle fractures in elderly patients with osteoporosis, evaluates the outcomes, and discusses surgical techniques.
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Orthop. Clin. North Am. · Apr 2013
ReviewBiomechanical considerations for surgical stabilization of osteoporotic fractures.
The incidence of osteoporotic fractures has been steadily rising along with the aging of the population. Surgical management of these fractures can be a challenge to orthopedic surgeons. ⋯ Advancements in implant design and fixation techniques have served to address these challenges and when properly applied, can improve overall outcome. The purpose of this review is to describe fixation challenges of common osteoporotic fractures and provide options for successful treatment.
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Monteggia described a fracture of the proximal third of the ulna with anterior dislocation of the radial head from both the proximal radioulnar and radiocapitellar joints. Application of this eponym to all injuries with radiocapitellar subluxation or dislocation has led to some confusion. In addition, there are substantial differences between Monteggia injuries in children and adults. With careful definition, specific subsets of patients may benefit from consideration as a separate type of Monteggia injury.