Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 1995
Determinants of reduced survival following hip fractures in men.
To assess determinants of poor survival after hip fractures in men, a population-based cohort study was conducted among 131 men in Rochester, MN, who had their first hip fracture during the period from 1978 to 1989, and an equal number of age-matched control men from the community. One hundred nine patients with fractures died during 373 person-years of followup, but only 75 control men died during 742 person-years of observation. ⋯ Discharge to a nursing home and low activity status also were predictors of death in the univariate analysis. Excess mortality among men with hip fractures can be explained best by interaction of the fracture with serious underlying medical conditions.
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Clin. Orthop. Relat. Res. · Oct 1995
Comparative StudyThe Frank Stinchfield Award. Pulmonary fat embolism in revision hip arthroplasty.
Unilateral cemented hip hemiarthroplasty was done on 16 dogs who subsequently had revision arthroplasty and who were divided into 1 control and 3 experimental groups: The first group had cement extraction using osteotomes; the second, using a high speed burr; the third, an ultrasonic tool. Hemodynamic and transesophageal echocardiographic monitoring were done. Postmortem pulmonary specimens were examined for differences in the quantity of fat emboli. ⋯ In these young dogs, minimal hemodynamic changes and no cardiac dysrhythmias occurred, which in part may be attributed to their good health. These changes may remain subclinical for patients with good cardiorespiratory reserve, or may become life threatening for those with poor reserve. By outlining the mechanisms of fat embolism in revision total hip arthroplasty, it may be possible to decrease future morbidity, especially in patients who frequently have cardiopulmonary disease.