Background: Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated.
Methods: We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003-2007 and 2007-2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes.
Findings: The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003-2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003-2007, compared with 7.6% per year over 2007-2011 (P<0.001 for the difference).
Interpretation: The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England.
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http://dx.doi.org/10.1097/MLR.0000000000000383 | DOI Listing |
J Bone Miner Metab
January 2025
Department of Internal Medicine 1, Shimane University Faculty of Medicine, Shimane, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
Introduction: Despite many studies on the prevalence of vertebral fractures (VFs), the VF prevalence at death in the Japanese population remains unclear.
Materials And Methods: We evaluated the VF prevalence at death in a Japanese cohort using autopsy imaging computed tomography (AiCT). We enrolled 365 cadavers (188 men, 177 women, mean age of 84.
Eur J Trauma Emerg Surg
January 2025
Department of Orthopedics, Huanggang Central Hospital of Yangtze University, Huanggang, 438000, Hubei, People's Republic of China.
Background: The number of patients with hip and femoral fractures is increasing and is expected to further increase in upcoming years due to the ageing population and the life expectancy of the general population. In this analysis, we aimed to systematically assess the post-operative complications associated with the pre-operative use of Aspirin in patients undergoing surgery for hip or femoral fracture.
Methods: Common online databases: Google Scholar, Web of Science, MEDLINE, Cochrane database, EMBASE ( www.
Arthroscopy
January 2025
Kansas City Orthopedic Alliance, 10777 Nall Avenue, Overland Park, KS 66224. Electronic address:
As surgeons, we strive to recognize and correct any mistakes that may occur before completing an operation, and importantly, do our best to avoid irreversible mistakes. Over-resection of the femoral cam lesion in patients having hip arthroscopy for femoroacetabular impingement syndrome has been considered irreversible. While cam under-resection is a technical complication of femoroacetabular impingement surgery to be avoided, avoiding this at the expense of over-resection of the proximal femur is of great concern.
View Article and Find Full Text PDFJ Am Acad Orthop Surg Glob Res Rev
January 2025
From the Department of Orthopaedics, University of Missouri-Kansas City, Kansas City, MO (Dr. Amin, Dr. Krumme, Dr. Gause, Dr. Dubin, and Dr. Cil), and the Department of Orthopaedics, Kansas City Orthopaedic Alliance, Leawood, KS (Dr. Krumme).
Geriatric femoral neck fractures are common orthopaedic injuries, which are associated with a high morbidity and mortality. Arthroplasty is the optimum treatment for many of these injuries, but debate exists regarding optimal surgical strategy. Multiple recent investigations have demonstrated strong superiority for cemented stems as compared with noncemented fixation with a decreased risk of periprosthetic fracture, shorter length of stay, lower cost, and decreased rate for revision surgery.
View Article and Find Full Text PDFActa Orthop
January 2025
Department of Orthopaedic Surgery, Health Møre and Romsdal HF, Kristiansund Hospital, Kristiansund; Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.
Background And Purpose: The optimal approach to the hip joint in patients with displaced femoral neck fractures (dFNF) receiving a total hip arthroplasty (THA) remains controversial. We compared the direct lateral approach (DLA) with the direct anterior approach (DAA) primarily on Timed Up and Go (TUG), and secondarily on the Forgotten Joint Score (FJS), the Oxford Hip Score (OHS), EQ5D-5L, and the EQ5D-VAS.
Methods: Between 2018 and 2023, we conducted a randomized controlled trial including elderly patients with dFNFs treated with THA.
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