Background/Objectives To quantify the occurrence of myocardial infarction (MI) occurring in the early postoperative period following surgical hip fracture repair and estimate the impact on one-year mortality. Design This study is a population-based, historical cohort study of patients who underwent surgical repair of a hip fracture. This studyutilized the computerized medical record linkage system of the Rochester Epidemiology Project. Setting Academic and community hospitals, outpatient offices and nursing homes in Olmsted County, Minnesota. Participants In the 15-year study period (1988–2002), 1116 elderly patients underwent surgical repair of a hip fracture. Measurements At the end of the first seven days following hip fracture repair, patients were classified into one of three groups: clinically verified MIs (cv-MI), subclinical myocardial ischemia (sc-MI) and no myocardial ischemia. One-year mortality was compared between these groups. Multivariate models assessed risk factors for early postoperative cv-MI and one-year mortality, respectively. Results Within the first seven days following hip fracture repair, 116 (10.4%) patients experienced cv-MIs and 41 (3.7%) had sc-MIs. Overall 1-year mortality rate was 22% and there was no difference between those with sc-MIs and those with nomyocardial ischemia. One-year mortality for those with cv-MI was significantly higher than the other two groups (35.8%). Occurrence of early postoperative cv-MI, male gender, and histories of heart failure or dementia were independently associated with increased one-year mortality; while, pre-fracture home residence and preoperative higher hemoglobin were protective. Conclusion Early postoperative, clinically verified, MIs following hip fracture repair exceeds rates following other major orthopedic surgeries and is independently associated with increased one-year mortality.

Patients who use a modern prosthesis following hemipelvectomy demonstrated good clinical function with and without their prosthesis. Although health status scores were decreased in the physical component, mental component scores were equal to healthy controls.

Neuropathic pain (NP) can have either central nervous system causes or ones from the peripheral nervous system. This article will focus on the epidemiology, classifications, pathology, non-invasive treatments and invasive treatments as a general review of NP involving the peripheral nervous system. NP has characteristic symptomatology such as burning and electrical sensations. It occurs in up to 10% of the general population. Its frequency can be attributed to its occurrence in neck and back pain, diabetes and patients receiving chemotherapy. There are a wide range of pharmacologic options to control this type of pain and when such measures fail, numerous interventional methods can be employed such as nerve blocks and implanted stimulators. NP has a cost to the patient and society in terms of emotional consequences, quality of life, lost wages and the cost of assistance from the medical system and thus deserves serious consideration for prevention, treatment and control.

Background:Restoring touch perception for individuals with upper extremity limb loss is an ambitious task. It is important to understand how persons with upper limb loss think this would be best achieved.Methods:An anonymous online survey was developed to obtain data from prosthetic users. Participants ranked the perceived acceptability and effectiveness of noninvasive sensory feedback to areas of intact sensation not typically involved in sensory feedback (i.e., the arm). The focus was on 4 main types of haptic information—object contact, proprioception, surface texture, and grasp force—as well as how best to convey those senses with various stimuli. The users were asked to grade themselves in certain tasks and then analyze which tasks would be improved with sensory feedback. Associations were explored between demographic characteristics and interest in sensory feedback.Results:Nationally, prostheses providers sent more than 2000 email invitations to the online survey and received 142 unique responses. Responses indicated interest in sensory feedback through prosthetic limbs by individuals with upper limb loss. The most popular pairing of haptic information with sensory substitution was grasp force paired with gentle vibration. Tasks that most persons taking the survey agreed would benefit from sensory feedback were zipping a jacket, tying shoes, buttoning a shirt, and using a cup. No difference was observed in interest between sex and employment status, but a significant decrease (P = .004) was seen in interest among participants with more years of prosthetic use.Discussion:The results from this national survey of upper extremity prosthetic users can be used to help guide the development of noninvasive sensory feedback options.