Guidelines for the management of hip fractures recommend timely identification, analgesia and optimisation, in order to facilitate prompt surgical repair. In achieving these aims, multidisciplinary care is essential. In this case series, we present five patients who received bedside pericapsular nerve group (PENG) blocks by emergency physicians in collaboration with the anaesthesia team for pain management following hip fracture. The PENG block is a novel motor- and opioid-sparing technique, which offers long-lasting analgesia and requires less volume than other blocks. In all of the cases in this series, the blocks were performed successfully in a short period of time, without complication. All patients reported a clinically important reduction in pain scores. Patients with hip fracture are often medically complex, and while early surgery is not always possible, pain management should be addressed from an early point in their hospital admission. Multidisciplinary input into peri-operative pathways can enhance the provision of analgesia in the emergency department, by allowing anaesthetists and emergency physicians to work together for the benefit of these often-frail patients.
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http://dx.doi.org/10.1002/anr3.12118 | DOI Listing |
Sci Rep
January 2025
Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.
The best treatment method for reverse obliquity intertrochanteric fractures (ROIFs) is still under debate. Our team designed the modified proximal femoral nail (MPFN) specially for treating such fractures. The objective of this research was to introduce the MPFN device and compare the biomechanical properties with Proximal Femoral Nail Antirotation (PFNA) and InterTAN nail via finite element modelling.
View Article and Find Full Text PDFJ Bone Miner Res
January 2025
San Francisco Coordinating Center, California Pacific Medical Center Research Institute and University of California, San Francisco, CA 94158, United States.
Bone mineral density (BMD) levels achieved on osteoporosis treatment are predictive of subsequent fracture risk, and T-score > -2.5 has been proposed as a minimum treatment target for women with osteoporosis. Knowing the likelihood of attaining target T-scores with different medications for different baseline BMD levels can help determine appropriate initial treatment for individual patients.
View Article and Find Full Text PDFNutrients
January 2025
Faculty of Food Science and Nutrition, University of Iceland, 102 Reykjavík, Iceland.
Background: Malnutrition predicts poor outcomes following hip fracture, affecting patient recovery, healthcare performance, and costs. Evidence-based guidelines recommend multicomponent, interdisciplinary nutrition care to improve intake, reduce complications, and enhance outcomes. This study examines global variation in oral nutrition support for older (65+ years) hip fracture inpatients.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Orthopedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea.
: Alzheimer's disease (AD) is the most common neurodegenerative disease in the older adult population and is often associated with reduced physical activity. Reduced activity and mechanical loading subsequently reduce bone mineral density and increase risk of osteoporosis. Bisphosphonates (BPs) offer preventative effects on osteoporotic fractures in the general population, but their effects on patients with AD are less known.
View Article and Find Full Text PDFMedicina (Kaunas)
January 2025
Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmundae-ro, Dong-gu, Gwangju 61453, Republic of Korea.
Managing periprosthetic femoral fractures is challenging, particularly in osteoporotic patients with fragile bones. Revision with a long stem is commonly considered but may fail to provide adequate fixation and stability in fragile bones. A novel approach using sandwiched strut allografts and controlled bone crushing with robust cable fixation can offer mechanical support and provide secondary stability to the loosened femoral stem and can be considered a treatment option for low-demand patients.
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