Is there a time when we should treat a fresh hip fracture in a physiologically elder patient with palliative care?

Injury

University of Calgary, 0490 McCaig Tower, Foothills Hospital, 3134 Hospital Drive NW Calgary, Alberta, T2N 5A1, Canada. Electronic address:

Published: July 2023

HISTORY - A 92-year-old female patient presents to the Emergency Room with a displaced intertrochanteric hip fracture after a fall from bed. She lives in a full care nursing home with severe dementia and wears an adult diaper. She does not walk anymore (for 3 months) and the family decision makers (they have power of attorney) have decided that she is not a surgical candidate except under extreme circumstance. Medically, she has moderate aortic regurgitation and a long history of chronic pulmonary fibrosis that has required occasional oxygen supplementation. She has Type 2 diabetes and takes oral meds for this. She has swallowing difficulties and eats mostly pureed food. She only communicates when she has pain and does not recognize her family when they visit. Her hemoglobin and electrolytes are within normal limits. Her vitals are stable, and she is mildly hypertensive.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.injury.2023.05.030DOI Listing

Publication Analysis

Top Keywords

hip fracture
8
time treat
4
treat fresh
4
fresh hip
4
fracture physiologically
4
physiologically elder
4
elder patient
4
patient palliative
4
palliative care?
4
care? history
4

Similar Publications

Background: A scarcity of data exists concerning atrial fibrillation (AF) during the perioperative stage of non-cardiothoracic surgery, particularly orthopedic surgery. In addition, given the frequency and significant impact of AF in the perioperative period, therefore our aim was to identify prognosis and predictors of elderly hip fracture patients with perioperative AF.

Methods: An examination of hip fracture patients at the Third Hospital of Hebei Medical University, who had been hospitalized from January 2018 to October 2020 in succession, was conducted retrospectively.

View Article and Find Full Text PDF

Introduction And Importance: Neglected posterior hip dislocations in adults are rare, particularly when untreated for years. In developing nations, patients often rely on traditional bone setters, leading to delayed diagnosis and increased complications. Adult hip dislocations carry a higher risk of avascular necrosis and require complex treatments.

View Article and Find Full Text PDF

The Management of Bone Defects in Rett Syndrome.

Calcif Tissue Int

January 2025

Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.

Rett syndrome (RS) is a rare neurodevelopmental disorder primarily caused by mutations in the X-linked methyl-CpG binding protein 2 (MECP2) gene, responsible for encoding MECP2 which plays a pivotal role in regulating gene expression. The neurological and non-neurological manifestations of RS vary widely in severity depending on the specific mutation type. Bone complications, mostly scoliosis but also osteoporosis, hip displacement, and a high rate of fractures, are among the most prevalent non-neurological comorbidities observed in girls with RS.

View Article and Find Full Text PDF

Patients with radiographic axial spondyloarthritis (r-axSpA) experience a higher prevalence of fragility fractures, though the pathophysiology of osteoporosis associated with this disease remains poorly understood. The objective of this study was to evaluate the histomorphometric data in r-axSpA patients. Male r-axSpA patients up to 55 years old were enrolled in this cross-sectional study.

View Article and Find Full Text PDF

Aseptic loosening (AL) of artificial hip joints is the most common complication following hip replacement surgery. A total of eight patients diagnosed with AL following total hip arthroplasty (THA) undergoing total hip replacement and eight control patients diagnosed with avascular necrosis of femoral head (ANFH) or femoral neck fracture undergoing THA were enrolled. The samples of the AL group were from synovial tissue surrounding the lining/head/neck of the prosthesis, and the samples of the control group were from the synovium in the joint cavity.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!