Neck of femur fractures in the elderly: Does every hour to surgery count?

Background: The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.Methods: A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. Results: In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.Conclusions: Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery & complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study.

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Seizures Causing Simultaneous Bilateral Neck of Femur Fractures

Case Reports in Orthopedics ◽

10.1155/2019/4570578 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Dane Gary Maimin ◽

Livan Meneses-Turino

Keyword(s):

Case Report ◽

Electroconvulsive Therapy ◽

Bone Disease ◽

Metabolic Bone Disease ◽

Index Patient ◽

The Elderly ◽

Low Energy ◽

Neck Of Femur ◽

Femur Fractures ◽

Metabolic Bone

Neck of femur fractures are a ubiquitous injury seen by orthopaedic surgeons. In the elderly, these fractures usually occur after a low energy fall, and are invariably unilateral injuries. Bilateral neck of femur fractures have been reported in patients with metabolic bone disease, after electroconvulsive therapy, and in association with stress fractures. The otherwise healthy index patient in this case report presented most unusually, with simultaneous, bilateral neck of femur fractures that were sustained during a seizure.

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Post-operative mortality and factors related to mortality after bipolar hemiarthroplasty in patients with femoral neck fractures

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4520 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2604-2608

Author(s):

Prabhakaran A ◽

Selvakumar P ◽

Krishnagopal R ◽

Anisha Rao

Keyword(s):

Hip Fractures ◽

Small Sample Size ◽

The Elderly ◽

Small Sample ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Medical College ◽

Femur Fractures ◽

Gandhi Medical College ◽

Surgical Duration

Hip fractures are a common entity in the elderly. Hemiarthroplasty is a common treatment option for displaced neck of femur fractures and have been found to be successful in restoring mobility, reducing pain and improving quality of life following hip fractures in elderly. Many studies have reported that advanced age, male gender, long term stay in the intensive care unit, poor postoperative mobilization ability, a poor or dependent ADL score preoperatively, multiple comorbidities which result in a high ASA score have been associated with higher mortality. A retrospective study was done at the Department of Orthopaedics at Mahatma Gandhi Medical College and Research Institute, Pondicherry which included all patients who underwent hemiarthroplasty (both cemented and uncemented) from 2017-2020. The details of patients satisfying the inclusion criteria were obtained from the medical records department and were analysed by a single investigator. In case the subjects had not reviewed following surgeries, details were obtained by telephonic communication. In our study of 40 patients, mortality was observed in 4 patients which included 3 females and 1 male. It was also observed that mortality was high between the ages of 61-80 years, patients with multiple comorbidities and patients with high ASA scores. The hazard ratio was calculated for 3 parameters namely age, time to surgery and surgical duration and is 1.014, 0.842 and 0.984 respectively but this was not found to be statistically significant. This may due to the small sample size and retrospective nature of our study.

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Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study

Injury ◽

10.1016/j.injury.2015.06.047 ◽

2015 ◽

Vol 46 (10) ◽

pp. 1988-1991 ◽

Cited By ~ 15

Author(s):

S.C. Jonas ◽

R. Shah ◽

N. Al-Hadithy ◽

M.R. Norton ◽

S.A. Sexton ◽

...

Keyword(s):

Case Control Study ◽

The Elderly ◽

Case Control ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Femur Fractures ◽

Control Study

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Correction to: Hemiarthroplasty for neck of femur fractures: to cement or not? A systematic review of literature and meta-analysis

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-019-02488-2 ◽

2019 ◽

Vol 29 (8) ◽

pp. 1835-1836

Author(s):

Prasoon Kumar ◽

Rajesh Kumar Rajnish ◽

Deepak Neradi ◽

Vishal Kumar ◽

Saurabh Agarwal ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Review Of Literature ◽

Neck Of Femur ◽

Femur Fractures

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Impact of COVID-19 pandemic on hip fractures: the central London experience COVID-related urgent geriatric hip trauma (COUGH) study COVERT ( COVid Emergency-Related Trauma and orthopaedics) collaborative

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-021-02687-z ◽

2021 ◽

Author(s):

Chang Park ◽

Kapil Sugand ◽

Arash Aframian ◽

Catrin Morgan ◽

Nadia Pakroo ◽

...

Keyword(s):

Best Practice ◽

Neck Of Femur ◽

Health Crisis ◽

Femur Fractures ◽

Time Period ◽

Vulnerable Patients ◽

Significant Difference ◽

Usual Residence ◽

Hip Trauma ◽

The Impact

Abstract Introduction COVID-19 has been recognized as the unprecedented global health crisis in modern times. The purpose of this study was to assess the impact of COVID-19 on treatment of neck of femur fractures (NOFF) against the current guidelines and meeting best practice key performance indicators (KPIs) according to the National Hip Fracture Database (NHFD) in two large central London hospitals. Materials and methods A multi-center, longitudinal, retrospective, observational study of NOFF patients was performed for the first ‘golden’ month following the lockdown measures introduced in mid-March 2020. This was compared to the same time period in 2019. Results A total of 78 cases were observed. NOFFs accounted for 11% more of all acute referrals during the COVID era. There were fewer overall breaches in KPIs in time to theatre in 2020 and also for those awaiting an orthogeriatric review. Time to discharge from the trust during the pandemic was improved by 54% (p < 0.00001) but patients were 51% less likely to return to their usual residence (p = 0.007). The odds ratio was significantly higher for consultant surgeon-led operations and consultant orthogeriatric-led review in the post-COVID era. There was no significant difference in using aerosol-generating anaesthetic procedures or immortality rates between both years. Conclusion The impact of COVID-19 pandemic has not adversely affected the KPIs for the treatment of NOFF patients with significant improvement in numerous care domains. These findings may represent the efforts to ensure that these vulnerable patients are treated promptly to minimize their risks from the coronavirus.

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