Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2023
The risk analysis of perioperative complications of cementless hip arthroplasty in octogenarians.
Hip arthroplasty is exposed to demographic change as patients age. Analysis of risk factors for surgical treatment decisions in the group of ≥ 80-year-old patients is crucial. Healthcare systems in developed countries are being tested medically and financially by the ageing population. Therefore, this study analysed the perioperative complications of cementless primary hip arthroplasty in octogenarians and compared them with patients aged ≤ 60 years. ⋯ The study reveals that primary cementless hip prosthesis implantation is a safe procedure without increased incidence of surgery-related complications. Increased attention should be paid to interdisciplinary preoperative optimisation (adjustment of blood pressure, blood transfusions, if necessary, safe exclusion of urinary tract infections) and postoperative care of octogenarians (tight laboratory examinations, geriatric co-attendance).
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Arch Orthop Trauma Surg · Jun 2023
Outcomes of ultra-old vs old patients after hip fracture surgery: a matched cohort analysis of 1524 patients.
Surgical management of geriatric hip fractures yields improved functional outcomes with decreased morbidity and mortality. Cohort studies have suggested that the older patients within the geriatric age group have worse outcomes with surgery, However, these studies inherently report inflated risks due to poor handling of confounders and have inadequately age-stratified their geriatric population. ⋯ The 1-year mortality of surgically-managed geriatric hip fracture patients older than 85 years of age is not determined by age alone. Patients aged 85 years and above are at higher risk for pneumonia postoperatively. Ultra-old hip fracture patients with an intertrochanteric fracture are more likely to have poorer function at 1 year after hip fracture surgery.
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Arch Orthop Trauma Surg · Jun 2023
Morbidities and prognostic factors after tibial pilon fracture: impact on patients.
This study aims primarily to characterize the sequelae and morbidity associated with tibial pilon injuries from the patients' perspectives in terms of multiple surgical interventions, duration of hospital stay, downtime from work, loss of productivity and impact on patients' lives. The secondary aim is to review the associated risk factors for these morbidities. ⋯ Tibial pilon fractures leads to significant morbidities with profound negative impact on patients' lives in terms of multiple surgical interventions required, prolonged hospital stay, need for readmissions and prolonged downtime from work. These morbidities from patients' perspective should be emphasized to patients and employers to manage their expectations and potential limitations.
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Arch Orthop Trauma Surg · Jun 2023
Staged Ilizarov distraction histogenesis and corrective reconstruction for severe malunited calcaneal fractures.
Severe calcaneal malunion is a clinical conundrum for the difficulty of calcaneal reconstruction without soft tissue complications. The aim of this study is to introduce the treatment strategy and preliminary results of staged Illizarov distraction histogenesis and corrective reconstruction for severe malunion of calcaneal fractures. ⋯ Staged Ilizarov distraction histogenesis and corrective reconstruction is a safe and effective treatment strategy for reducing soft tissue complications and improving reconstruction results in surgical correction of severe calcaneal malunion.