Epidemiology of fractures of the proximal third of the femur in elderly patients

Abstract

ObjectiveThis was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo.MethodsThe subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra-hospital mortality rate were evaluated.ResultsThe 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low-energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was 7 days. The intra-hospital mortality rate was 7.1%.ConclusionThe patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra-hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented.

Preoperative Hemoglobin Dynamics in Patients with Trochanteric Fractures. A multivariate analysis

“…The preoperative interval ranged from a few hours to 19 days, averaging 4.92 ± 2.76 days. Compared to literature data, it was lower compared to the South American population [15] and similar to the United States and Western Europe. Intertrochanteric fractures (3.64 ± 1.60 days), trochatero-diaphysaire (4.60 ± 2.72 days) and basicervical fractures (4.71 ± 2.82 days) (p = 0.336) showed mean values without significant differences between sexes or age groups.…”

Perfil epidemiológico de idosos com fratura proximal de fêmur atendidos no Hospital Regional do Baixo Amazonas, Santarém, PA, Brasil

“…Martins, Campos, & Santos (2018) (Rocha, Azer, & Nascimento, 2009 com haste cefalomedular; e 18,5% com placa e parafuso deslizante. Daniachi, et al (2015), em seu estudo com 113 idosos com fratura proximal de fêmur, apresentou 5 pacientes que não foram operados; 39 foram submetidos à substituição articular;…”

“…Tempo de internação, tempo para realização da cirurgia , vítimas de fraturas, e encontraram que 64,1% eram mulheres, assim comoGomes, et al (2015), em que 64,51% correspondiam ao sexo feminino. SP Apesar de ter sido realizado em outro local e com amostra diversa, na pesquisa deDaniachi, et al (2015) houve uma predominância ainda maior das mulheres com (75%), com idade média equivalente de 79 anos de idade, assim como nade Paula, et al (2011), que foi de 71,9%, com idade média de 78,4 anos. Por outro lado,Martins Campos, & Santos (2018) encontraram um percentual menor, de 59,6% de idosos do sexo feminino com fratura de extremidade proximal de fêmur.…”

Temperatura corporal do paciente idoso no período pós‑operatório

“…Sabe-se que a osteossíntese, por gerar estabilidade e retorno funcional mais precoce, é o tratamento preconizado para paciente com fratura proximal de fêmur. O aumento dessas fraturas na população idosa deve-se, principalmente, à maior incidência de quedas da própria altura, e está relacionada a vários fatores, como idade avançada, osteoporose, diminuição da força muscular, geometria do quadril e predisposição genética 11 .…”