Influence of postoperative analgesia on systemic inflammatory response and postoperative cognitive dysfunction after femoral fractures surgery: a randomized controlled trial.

Background And Objectives: To investigate the possible effect of postoperatively applied analgesics-epidurally applied levobupivacaine or intravenously applied morphine-on systemic inflammatory response and plasma concentration of interleukin (IL)-6 and to determine whether the intensity of inflammatory response is related to postoperative cognitive dysfunction (POCD).

Methods: This is a randomized, prospective, controlled study in an academic hospital. Patients were 65 years and older scheduled for femoral fracture fixation from July 2016 to September 2017.

The proximal femoral nail antirotation (PFNA) in the treatment of proximal femoral fractures.

Proximal femoral fractures, especially in elderly persons with osteoporosis, present a challenge for the traumatologist. While the dynamic hip screw (DHS) became the implant of choice for the treatment of stable fractures, the ideal implant for the treatment of unstable fractures remains an issue. In our experience, Proximal Femoral Nail Antirotation (PFNA) is an excellent device for osteosynthesis as it can be easily inserted, it provides angular and rotational stability and allows early weight bearing on the affected limb.