[Result of the update of the clinical pathway for hip fracture in the older adult at a university hospital in Madrid].

Background And Objectives: Orthogeriatric management with clinical pathways (CP) in hip fracture (HF) has been shown to be superior to other models. We studied whether updating the CP, through prioritization of admission and surgery, improvement in the prevention and treatment of delirium, management of anticoagulants and antiplatelet agents and the use of perioperative peripheral nerve block, modifies surgical delay, stay, readmissions, mortality, suffering delirium and functional status at discharge.

Material And Method: A retrospective observational study of unicenter cohorts of 468 patients with HF, 220 from 2016 (old VC) and 248 from 2019 (new VC).

Percutaneous fixation of displaced proximal humeral fractures: indications based on the correlation between clinical and radiographic results.

We evaluated 74 patients with displaced proximal humeral fractures (mean age, 70.9 years) treated with closed reduction and percutaneous pinning. Fractures were classified radiographically following Neer's system, and the quality of reduction was assessed according to Kristiansen and Kofoed.

Rotator cuff impingement due to enchondroma of the acromion.

We report the case of a patient with a long standing clinical history of subacromial impingement, in which plain radiographs and CT-scan revealed a well-circumscribed lucent lesion expanding the undersurface of the acromion. MRI showed the subacromial fat to be completely obliterated and the infraspinatus tendon deformed due to compression by a mass localised at the acromion. The acromial lesion was curetted, and histopathologic analysis was consistent with the diagnosis of enchondroma.