Introduction The aim of the study was to compare the mortality risk and complication rate after operative treatment of pertrochanteric fractures with primary arthroplasty, dynamic hip screw (DHS) or proximal femoral nail (PFN). Patients and methods Clinical records including X-rays of all patients with trochanteric femoral fractures, except pathologic fractures and a minimum age of 60 years, which were treated between 1992 and 2005 were entered in this retrospective study. Of these 283 patients, 132 were treated by primary arthroplasty, 109 with a DHS and 42 with a PFN. Survival after 1 year and complications, which had to be treated within this period were our main outcome measurement. InXuencing cofactors such as age, gender and comorbidities were reduced by multivariate logistic regression analysis. Results Mortality was signiWcantly inXuenced by age, gender and amount of comorbidities but not by fracture classiWcation. Primary hip arthroplasty did not bear a higher 1-year mortality risk than osteosynthesis in a multiple regression analysis. The main complication with DHS and PFN were cutting out of the hip screw and non-union with a revision rate of 12.8%. With the introduction of hemiarthroplasty, the postoperative dislocation rate decreased from 12 to 0%. Conclusion For stable fractures a dynamic hip screw (DHS) and for unstable fractures a short proximal femoral nail (PFN) can be recommended. The mortality risk of primary cemented arthroplasty did not diVer signiWcantly from the other treatment groups and because of its low complication rate it is a viable treatment option for trochanteric fractures if osteoporosis prevents from full weight bearing or if osteoarthritis makes further operations likely. Primary total hip replacement should be handled with care due to its signiWcantly higher dislocation rate compared with hemiarthroplasty especially in unstable fractures.
In a society with an aging population, the preventive healthcare importance of physical activity in middle-aged and older adults is growing. The purpose of the study "Living an active life - age and aging in Baden-Wuerttemberg" is to acquire generalisable data of practical relevance for the 50- to 70-year-old population of Baden-Wuerttemberg. The main themes of this study are sports, exercise, and health-related and lifestyle aspects--from both a current and a biographical perspective. Following conceptualization and a test run, the survey was conducted by means of a computer-assisted telephone interview (CATI) in the period from May to October 2006. 982 men and 1,020 women responded. The percentage of respondents with a high level of education was disproportionately high, as is frequently the case for telephone surveys. Due to the resultant bias, the data was weighted by age, gender and education on the basis of the German Microcensus 2004. In addition to serving as a health report on the middle-aged and older adult population, this basic survey generated representative data on physical/sporting activity among older people in Baden-Wuerttemberg, and can be used as a reliable basis for designing future preventive measures. First analyses show that people with higher educational levels and good health, and non-smokers, people with balanced diet and normal weight are more likely to do sporting activities.
We confirm the excellent survival rates of the Allofit cup as reported by the development centres, supporting the ongoing use of the cup at our institution.
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