We think that, in addition to the shorter delay in surgery, internal fixation choice led to decrease the mortality rate of intertrochanteric femur fracture patients. In conclusion, to decrease the mortality rate after hip fracture, since age and sex cannot be changed, needless delays in surgery should be avoided. Also, we recommend internal fixation and regional anesthesia to decrease the mortality rate.
A femoral rotational malalignment of ≥10° is symptomatic for the patients, and the hip, knee, and patellofemoral joints were affected. Because of the possibly altered joint loadings and biomechanics, these could render patients prone to degenerative joint disease. In addition, due to the high rates of rotational malalignment after femoral shaft fracture and consequent malpractice claims, it is important for surgeons to be more aware of rotational alignment during surgery.
Although preservation of high activity level has been reported in active young patients after periacetabular osteotomy (PAO) for the treatment of symptomatic hip dysplasia, there is limited evidence whether a dancer may be able to resume dancing after PAO. We asked whether female dancers experience improvement in pain and sports-related activities and return to dance following PAO. Between 1997 and 2014 we performed a total of 44 PAOs in 33 female dancers with symptomatic hip dysplasia. The mean age was 20.3 years (SD 5.6 years) and the median follow-up was 2.7 years (IQR 1.7–5.9 years). The Hip Disability and Osteoarthritis Outcome Score (HOOS), the modified Harris hip score (MHHS) and hip motion were collected preoperatively and at most recent follow-up. Return to dance was recorded from self-reported questionnaires and medical record review. Female dancers reported an improvement in HOOS total scores of nearly 20 points (P = 0.007) and MHHS improved over 17 points (P = 0.01) from preoperative to most-recent follow-up. Out of the 30 patients for whom information about return to dance was available, 19 (63%; 95% CI = 43.9–79.5%) had returned to dance at an average of 8.8 months (±3.6 months) after PAO. With the numbers available we did not identify any factors associated with returning to dance in this cohort. Improvement in hip pain, sports-related activities and hip function may be expected following PAO in young female dancers. Most female dancers can expect to return to dance during the first year after surgery.
High mortality rates and morbidities after major lower limb amputations emphasize the importance of preventive measures and foot care in patients with diabetes.
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