Extracts from "Clinical Evidence": Hip fracture

Gillespie, W. J.

doi:10.1136/bmj.322.7292.968

Cited by 79 publications

(45 citation statements)

References 29 publications

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“…In intertrochanteric hip fractures, the fracture line commences at or near the lower part of the junction of the neck and shaft, and goes through the greater and the lesser trochanters. Subtrochanteric fractures occur at the region between the lesser trochanter and a point 5 cm distal (Gillespie, 2001;Nolla and Rozadilla, 2004;Lee and Ertl, 2008). These fractures are also categorized according to severity and degree of stability; the Garden classification is an emblematic model (Canale, 1998).…”

Section: Methodsmentioning

confidence: 99%

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Hip fractures in the Portuguese archaeological record

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Lopes

et al. 2011

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Fractures are ubiquitous in the archaeological record but the majority of these are the consequence of a traumatic incident and do not reflect any loss of strength inherent to the bone. So-called fragility fractures, particularly hip fractures, are considered uncommon occurrences in skeletal populations from the past. Nevertheless, evidence of this type of fracture in the archaeological record is increasing. A methodical search for possible hip fractures in the excavation reports, theses and monographs housed in the Department of Anthropology of the University of Coimbra presented an occasion to describe six hip fractures, previously unpublished, from different Portuguese archaeological sites and to challenge the widespread assumption that hip fractures were nearly non-existent in the past.

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Section: Methodsmentioning

confidence: 99%

“…Fractures that occurred above a point 5 cm underneath the distal part of the lesser trochanter up to the head of the femur were considered hip fractures (Gillespie, 2001;Nolla and Rozadilla, 2004). There are several categorization schemes for these fractures.…”

Section: Methodsmentioning

confidence: 99%

Hip fractures in the Portuguese archaeological record

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Lopes

et al. 2011

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“…Current annual healthcare costs associated with hip fractures are between 10.3 billion USD and 15.2 billion USD [8], and the incidence of hip fractures is expected to rise substantially as an increasing proportion of the population ages [3]. Hip fractures are associated with mortality ranging from 12% to 37% 1 year after surgery [8,15,16] and substantial compromises to the patients' quality of life [17]. There is a disparity in outcomes between male and female patients, with the former having a greater mortality rate at 1 year and being more likely to experience a postoperative complication [1,11,14].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does a Multidisciplinary Team Decrease Complications in Male Patients With Hip Fractures?

Dossous

Ton

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Men with hip fractures are more likely to experience postoperative complications than women. The Medical Orthopaedic Trauma Service program at New York Presbyterian Hospital utilizes a multidisciplinary team approach to care for patients with hip fractures. The service is comanaged by an attending hospitalist and orthopaedic surgeon, with daily walking rounds attended by the hospitalist, orthopaedic resident, physical therapist, social worker, and a dedicated Medical Orthopaedic Trauma Service physician assistant. Questions/purposes We asked whether a multidisciplinary service for patients with hip fracture decreases (1) the incidence of inpatient complications in men, (2) the length of hospitalization, and (3) 90-day and 1-year mortality. Patients and Methods We retrospectively reviewed the charts of 74 men who had surgery for a nonperiprosthetic femoral neck, intertrochanteric, or subtrochanteric fracture for two 7-month periods before and after implementation of the Medical Orthopaedic Trauma Service. Age, ethnicity, comorbidity status, time to surgery, and postoperative complication data were collected. Regression modeling was used to evaluate the likelihood of postoperative complications, length of hospitalization, and 90-day and 1-year mortality while controlling for age, Charlson Comorbidity Index score, fracture type, and time from admission to surgery. Results We observed a decrease in the likelihood of experiencing at least one inpatient complication in male patients after implementation of the Medical Orthopaedic Trauma Service (odds ratio = 0.264). There was no difference in length of hospitalization, 90-day mortality, or 1-year mortality. Conclusions Multidisciplinary collaboration for patients with hip fractures can decrease the likelihood of experiencing inpatient complications in male patients.Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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“…En nuestro estudio el 50% de los pacientes recibió anestesia regional, puesto que uno de los procedimientos más frecuentes fue cirugía de fractura de cadera. El predominio de la cirugía de urgencia (60%) sobre la electiva también puede atribuirse a la alta frecuencia de cirugía de fractura de cadera; en nuestra institución esta patología se considera una urgencia por las consecuencias potenciales que tiene retardar la cirugía 17,18 .…”

Section: Discussionunclassified