Peri-implant femoral fractures in elderly: Morbidity, mortality, treatment options and good practices.

Purpose: Femur fractures are among the most common fractures treated surgically, representing a significant challenge for the orthopedic surgeon. Peri-implant femoral fractures (PIFFs) represent a rare complication of the surgical treatment. It is necessary to pay attention during osteosynthesis, evaluating not only the fracture site but the entire femoral skeletal structure, the characteristics of the fracture, the health comorbidities, and the risk of malunion and pseudarthrosis.

Techniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.

Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur.

Perioperative methadone compared to placebo in elderly hip fracture patients: a study protocol for a randomized controlled trial (MetaHip trial).

Background: Hip fractures are a source of severe pain among the elderly population and pose challenges due to limited analgesic tolerance. Perioperative methadone has shown promise in our pilot study suggesting a safe dose of 0.10 mg/kg, prompting further investigation into its benefits for elderly hip fracture patients.

Comparison of Management and Outcomes of Hip Fractures Among Low- and High-Income Patients in Six High-Income Countries.

Background: There is a perception that income-based disparities are present in most countries but may differ in magnitude. However, there are few international comparisons that describe income-based disparities across countries and none that focus on hip fractures.

Objective: To compare treatment patterns and outcomes of high- and low-income older adults hospitalized with hip fracture across six high-income countries.

Ipsilateral femoral head and intertrochanteric fractures with posterior subluxation of the hip: A rare case report.

Introduction: Hip fractures are common in elderly patients, often accompanied by comorbidities. These fractures can be combined with other injuries, such as a femoral head, neck, or shaft dislocation. The cause of this complex injury is not well-established, but factors like high-energy trauma or falls from a certain height may contribute.

Vitality index predicts walking independence in patients with hip fracture: A retrospective study.

This study aimed to determine if the vitality index predicts walking independence in inpatients with hip fractures and calculate a cutoff value. This retrospective cohort study included inpatients with hip fracture (N = 133). Logistic regression analysis was performed with walking independence at discharge and vitality index as the dependent and independent variables, respectively, and age, Berg balance scale (BBS), knee extension muscle strength, and revised Hasegawa's dementia scale at admission as covariates.

Ambient pollution at hip fracture units and impact on mortality and post-operative delirium: A hormetic effect?

There is increasing awareness of the deleterious effects of ambient pollution. The World Health Organisation (WHO) has recently advocated new safe limits of annual exposure for the three pre-dominant pollutants: fine particulate matter (PM2.5), coarse particulate matter (PM10) and nitrogen dioxide; namely 5μg/m3, 15μg/m3 and 10gμ/m3 respectively.

Do Cementless, Collared Stems Prevent Aseptic Loosening, Subsidence, and Periprosthetic Fracture in Total Hip Arthroplasty?

Modern total hip arthroplasty (THA) is one of the most common and successful orthopedic procedures performed, utilizing a variety of fixation methods, stem geometry and designs to provide immediate post-operative weight bearing. The purpose of this study was to determine the incidence of intraoperative periprosthetic fractures, subsidence rates and aseptic loosening between collared stems compared with non-collared tapered stems during THA. A retrospective chart review identified 983 THA cases performed by a single surgeon between 2013-2021.

Impact of hematologic inflammatory markers on the prognosis of geriatric hip fracture: a systematic review and meta-analysis.

Background: Geriatric hip fractures pose a significant health burden, and inflammation may play a role in the short- and long-term prognosis. However, the prognostic significance of hematologic inflammatory markers in geriatric patients with fractures is not understood. The aim of this systematic review and meta-analysis was to assess the prognostic implications of systemic inflammatory markers on the long-term mortality of older patients with hip fractures.

An overview of patients with intertrochanteric femoral fractures treated with proximal femoral nail fixation using important criteria.

Background: This study aimed to assess important criteria, including osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union, in patients with intertrochanteric femoral fractures treated with proximal femoral nail (PFN) fixation and to show their effect on clinical outcomes.

Methods: PFN fixation was applied in 73 patients (41 females, 32 males; mean age: 64.5 ± 6.

Comparison of surgical efficacy between direct anterior approach and posterolateral approach in the treatment of sarcopenia with femoral neck fractures.

Background: Femoral neck fracture (FNF) is a prevalent injury among the elderly, associated with significant morbidity and mortality. Total joint arthroplasty (TJA) has markedly enhanced the quality of life for many patients; however, the benefits of the direct anterior approach (DAA), which has gained popularity in recent years, remain a subject of debate. Sarcopenia frequently occurs in patients with FNF and is linked to adverse surgical outcomes.

Immediate weight bearing as tolerated versus delayed weight bearing following intramedullary fixation for geriatric intertrochanteric fractures: a post hoc analysis.

Background: Early weight bearing is crucial for fracture healing after osteosynthesis for intertrochanteric fractures (ITFs). The optimal period to start weight bearing after surgery is still under debate. The aim of this study was to compare immediate weight bearing (IWB) as tolerated with delayed weight bearing (DWB) following intramedullary fixationin elderly ITF patients.

An explainable and supervised machine learning model for prediction of red blood cell transfusion in patients during hip fracture surgery.

Aim: The study aimed to develop a predictive model with machine learning (ML) algorithm, to predict and manage the need for red blood cell (RBC) transfusion during hip fracture surgery.

Methods: Data of 2785 cases that underwent hip fracture surgery from April 2016 to May 2022 were collected, covering demographics, medical history and comorbidities, type of surgery and preoperative laboratory results. The primary outcome was the intraoperative RBC transfusion.

Discriminatory Accuracy of Fracture Risk Assessment Tool in Asian Populations: A Systematic Review and Meta-Analysis.

Background: This review explores the discriminative ability of fracture risk assessment tool (FRAX) in major osteoporotic fracture (MOF) and hip fracture (HF) risk prediction and the densitometric diagnosis of osteoporosis in Asian populations.

Methods: We systematically searched the EMBASE, Cochrane, and PubMed databases from the earliest indexing date to January 2024. Studies were included if FRAX was used to identify future osteoporotic fractures or a densitometric diagnosis of osteoporosis in an Asian population and reported the area under the curve (AUC) values.

Effectiveness of home-based exercise for functional rehabilitation in older adults after hip fracture surgery: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis was performed to assess effectiveness of home-based exercise compared with control interventions for functional rehabilitation in elderly patients after hip fracture surgery. Comprehensive literature search was performed on PubMed, EMBASE, Web of Science, Cochrane library, and Clinicaltrails.gov to identify eligible randomized controlled trials (RCTs).

The Associations Between Individual Anthropometric Measurements and Fracture Risk: A Mendelian Randomization Study.

Background: The primary objective of this study was to investigate and substantiate the possible causal connections between measurements of body dimensions and the likelihood of experiencing fractures.

Materials And Methods: We employed a two-sample Mendelian randomization (MR) analysis to examine the associations between anthropometric measurements and two specific traits-bone mineral density and fracture risk. To ensure the credibility of our causal conclusions, we used the inverse variance weighted (IVW) method along with various sensitivity analyses.

Quantitative computed tomography analysis of proximal femur bone mineral density and its relation to hip fracture risk.

Background: Hip fractures significantly reduce the quality of life and mobility of older adults. This study aimed to analyze the correlation between volumetric bone mineral density (vBMD) in different regions of the proximal femur as measured by quantitative computed tomography (QCT) and various subtypes of hip fractures.

Methods: This case-control study included patients over the age of 65 years admitted to Huadong Hospital Affiliated to Fudan University for hip fractures from November 2022 to December 2023; additionally, patients from the health examination center or outpatient center treated during the same period were included as a control group.

Optimizing surgical management of acetabulum fractures involving both columns using buttress plating of posterior column through AIP approach.

Introduction: Acetabulum fractures involving both columns are complicated injuries to treat, and achieving satisfactory post operative reduction with less extensile approaches is difficult. These injuries often require dual approaches, associated with their own share of complications. The anterior intrapelvic approach (AIP) addresses both columns through a single approach, minimizing these complications.

Extracapsluar lipohaemarthrosis: A case report and review of literature.

In the setting of trauma, occurrence of intracapsular lipo-hemarthrosis is not uncommon, highly useful and well known imaging finding. Occurrence of extracapsular lipohaemarthrosis is uncommon and have been noticed around the large joints like knee, hip, and shoulder joints. Extracapsular lipohaemarthrosis is rare especially around small joints like wrist joint.

Diagnostic value of thromboelastogram and thrombus molecular markers in early detection of deep vein thrombosis in patients with lower extremity fracture.

Background: Deep vein thrombosis (DVT) is an obstructive disease with a hindering venous reflux mechanism. The aim of this study was to identify independent risk factors for deep vein thrombosis (DVT) in patients with traumatic lower extremity fractures and assess the diagnostic value of thromboelastogram (TEG) and thrombus molecular markers.

Methods: Reviewed patients with lower extremity fractures were admitted from October 2022 to September 2023.

Clinical outcomes of open reduction and internal fixation combined with sartorius muscle iliac bone graft transplantation for displaced femoral neck fractures in middle-aged and young adults: a retrospective analysis of 24 cases.

Objective: This study aimed to evaluate the clinical outcomes and complications of open reduction and internal fixation (ORIF) combined with sartorius muscle iliac bone graft transplantation (SIBFT) in the treatment of displaced femoral neck fractures in middle-aged and young adults.

Methods: A retrospective analysis was performed on 26 patients under the age of 60 with displaced femoral neck fractures (Pauwels III or Garden III-IV) treated at our institution between April 2019 to July 2022. All patients underwent open reduction and internal fixation (ORIF) through the Smith-Petersen (S-P) approach, augmented with a sartorius muscle iliac bone graft transplantation.

Fully-threaded cannulated screws versus partially-threaded cannulated screws for femoral neck fractures: a systematic review and meta-analysis.

Objective: Femoral neck fractures (FNFs) are a common orthopedic type, and there are many treatment methods for it, and cannulated screw internal fixation is currently one of the main treatment methods. The choice of fully threaded cannulated screw (FCS) or partially threaded cannulated screw (PCS) remains controversial. Therefore, we performed this meta-analysis to evaluate the outcomes of FCS and PCS in the treatment of FNF.

Effects of trehalose on bone healing, physical function, and pain in patients with pertrochanteric fractures: a randomized controlled trial protocol.

Background: Appropriate management of fractures is crucial for restoring natural bone function and preventing long-term complications. Previous research on animal models indicates that trehalose can improve bone fracture healing by inhibiting the inflammatory cascade. We hope that trehalose can accelerate bone fracture healing in humans, alleviate pain, and ultimately enhance the individual's quality of life.

Perceived barriers and facilitators of staff recruiting participants to a randomised controlled trial of a community rehabilitation intervention following hip fracture.

Background: Randomised controlled trials (RCTs) often struggle with recruitment and many need extensions which leads to delayed implementation of effective interventions. Recruitment to complex intervention trials have similar difficulties. Alongside this, the COVID-19 pandemic had a major impact upon trial recruitment.