No abstract

The aim of this study was to describe the consequences of hip fracture with respect to changes in residential needs and the ability to perform activities of daily life. Patients 50 years and older admitted to the two largest hospitals of Oslo with a hip fracture during the period May 1996 through April 1997 were identified. In November 1997 a questionnaire on residential needs, activities of daily life, hip pain and health status was sent to the patients still alive (n = 767). After reminders, the questionnaires of 593 patients (77%) were included. Logistic regression analysis was applied to assess items associated with functional limitation and need for residential care. The proportion of patients living in nursing homes increased from 15% before to 30% after the hip fracture, and men were twice as likely to move into a nursing home than women. Of the patients living in their own homes before the hip fracture, 6% of those < 75 years compared with 33% of those > 85 years had to move to nursing home after hip fracture. The proportion of patients walking without any aid decreased from 76 to 36%, and 43% of the patients lost their prefracture ability to move outside on their own. More than a fourth of the patients (28%) lost their ability to cook their own dinner after sustaining hip fracture. The probability of these events increased with increasing age. The probability of reporting inferior health status and for having hip pain that affected sleep after the fracture was unrelated to age. Many patients sustaining a hip fracture, and in particular the oldest patients, have reduced ability to perform activities of daily life.

The overall incidence of distal forearm fractures in Oslo is higher than in other countries and has not changed significantly when comparing the incidence of 1998/99 with 1979. Furthermore, the present data suggest that Asian immigrants in Oslo have a slightly lower fracture risk than ethnic Norwegians.

An algorithm for the paracetamol absorption test for gastric emptying, adjusting for individual pharmacokinetics, was recently developed. The aim of the present study was to validate the use of this algorithm. Furthermore, the algorithm was applied to elucidate whether a gastric tube interferes with the rate of gastric emptying. A caloric liquid meal with paracetamol was administered orally to nine healthy volunteers on two separate days. On one occasion, the subjects were intubated with a nasogastric tube and the meal was aspirated from the stomach 45 min after meal intake. The percentage of the meal retained in the stomach at the time of aspiration was determined by analyses of paracetamol in the aspirate and compared with calculations by the algorithm. On the other examination day, the same meal was ingested without tube and aspiration. The median percentage of the meal retained in the stomach at aspiration was 47% (range 33-70%) calculated by the algorithm and 48% (range 23-61%) based on the aspiration data. The correlation between the emptying parameters was r=0.97 (P < 0.001). The median of gastric emptying parameters was similar when the number of samples included in the calculation by the algorithm was reduced, but the range tended to increase. The gastric tube moderately inhibited gastric emptying during the period 20-40 min after meal intake (P < 0.05), but for the period from meal intake until start of aspiration, no inhibition was found. The present study demonstrates that the novel algorithm for the paracetamol absorption test provides valid estimates for gastric emptying.

Background Hemiarthroplasty has been shown superior to internal fixation for displaced femoral neck fractures (FNF) in the first 2 years. However, there are unanswered questions about the performance of hemiarthroplasty over the longer term compared with internal fixation. Questions/purposes We sought to compare hemiarthroplasty with internal fixation in terms of (1) outcomes scores for pain, hip function, and quality of life at a minimum of 5 years after surgery in a randomized trial. A secondary purpose was to compare (2) patient survival and (3) frequency of reoperation in the two groups. Methods A total of 222 consecutive patients older than 60 years, including those cognitively impaired, with FNF were randomized to either internal fixation with two parallel screws or bipolar hemiarthroplasty. At a minimum followup of 4.9 years (mean, 5.9 years; range, 4.9-7.2 years), 68 of the 70 surviving patients were examined by a study nurse and study physiotherapist blinded to initial treatment. Questionnaires on hip function (Harris hip score), quality of life (Eq5D), and activity of daily living function (Barthel ADL) were administered. The Barthel ADL index score was split into good function (score 95 or 100) and reduced function (score below 95).

No abstract

The incidence of hip fractures in women in Oslo has decreased significantly during the last decade and is now at a lower level than in 1978/1979. This reduction was not evident in men. The incidence of hip fractures in Oslo is, however, still the highest in the world.

The majority of the young patients with hip fracture have a history of low-energy trauma, comorbidity predisposing for falls or decreased bone strength, as well as several risk factors for osteoporosis. The BMD was significantly lower than in the reference population regardless of the trauma mechanism.