Morbidität und Letalität bei hüftgelenknahen Femurfrakturen im höheren Lebensalter

Raunest, J.; Engelmann, Robby; Jonas, Michael; Derra, E

doi:10.1007/s001130050735

Cited by 33 publications

(12 citation statements)

References 8 publications

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“…Sie sind bei bleibendem Verlust der Gehfähigkeit oft Ausgangspunkt für die physische und soziale Desintegration der geriatrischen und oft polymorbiden Patienten [2,12,28]. Primat der operativen Versorgung sollte daher das rasche Erreichen ausreichender Mobilität zur Wiedereingliederung in das gewohnte Lebensumfeld durch eine gering belastende und stabile Osteosynthese sein [6,20,22,28,30].…”

Section: Diskussionunclassified

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Welchen Einfluss hat das Implantat auf die perioperative Morbidität bei osteosynthetischer Versorgung pertrochantärer Femurfrakturen?

Käfer

Palm²,

Zwank³

et al. 2005

Z Orthop Ihre Grenzgeb

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Section: Diskussionunclassified

“…Primat der Behandlung ist daher die rasche Wiederherstellung einer ausreichenden Gelenkfunktion unter Vermeidung perioperativer, partiell immobilisationsbedingter Komplikationen [21,22,27].…”

Section: Introductionunclassified

Welchen Einfluss hat das Implantat auf die perioperative Morbidität bei osteosynthetischer Versorgung pertrochantärer Femurfrakturen?

Käfer

Palm²,

Zwank³

et al. 2005

Z Orthop Ihre Grenzgeb

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“…Furthermore early mobilization with full weight bearing is an important factor to reduce the number of postoperative complications like pneumonia or thrombosis [10].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Application of a Serum Protein Solution (Biseko®) After Proximal Femur Fracture of Elder Patients

Maier

Reinert

Lehnert

et al. 2007

Eur J Trauma Emerg Surg

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Fractures of the proximal femur are frequently seen in elderly people and will increase due to the demographic development of most industrialized countries. Early operation of dislocated fractures with either osteosynthesis or hemiprothesis has become a standard treatment for this type of injury. The high co-morbidity often leads to secondary complications like infections still resulting in a perioperative mortality rate of 11%. The perioperative infusion regime might influence the postoperative inflammatory response. Therefore Biseko(®), a serum protein solution, was compared to albumin and crystalloid infusion (Elomel). A total of 45 patients with proximal femur fractures were randomly assigned to either of the groups and received 500 ml of the infusion on 3 days starting from the day of operation. The Biseko(®) group showed significantly lower CRP levels, less infections and antibiotic treatment as well as a better clinical outcome referring to the TISS28 and APACHE Score. Concerning IL-6, IL-8, IL-10 and serum leukocytes no significant differences were observed. The result shows a beneficial influence of the serum protein solution Biseko(®) concerning the number of perioperative complications. The design of this study and the small number of patients does not yet allow any conclusion concerning the effectiveness of this treatment.

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“…B. Verkehrsunfälle oder Stürze aus großer Höhe, ursächlich zu beobachten sind [6]. Im Patientenkollektiv der medialen Schenkelhalsfrakturen hat man es zu einem hohen Prozentsatz mit multimorbiden älteren Patienten zu tun, deren Grunderkrankungen einen hochgradigen Risikofaktor für die Inzidenz perioperativer systemischer Komplikationen und Letalität darstellen [23,30,32]. Die Therapiewahl muss dem Rechnung tragen und ermöglichen, dass die Belastung des Patienten, auch durch mögliche Verkürzung der OP-Zeiten, minimiert wird.…”

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Duokopfprothesenimplantation bei medialer Schenkelhalsfraktur im hohen Lebensalter – Klinische und radiologische Ergebnisse

Müller¹,

Bayer²,

Szarzynski³

et al. 2008

Zentralbl Chir

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In our study, we retrospectively evaluated 203 patients with medial or lateral femoral neck fractures who received 210 bipolar prosthesis (7 bilateral implantations) at our institution. 204 patients underwent cemented bipolar hemiarthroplasty. These included 149 females and 54 males with a median age of 82 (46-97) years. At the time of surgery 144 patients (71%) suffered from more than 3 medical conditions. We conducted our follow-up examination at a median of 27.9 months after the operation, at which time 97 patients (48%) had already died. On examination, 17% of our 76 patients had a Harris hip score between 90 and 100 and 20% between 80 and 89 or 70 and 79, respectively. 43% had a score of less than 70. In 20 patients (57%) we found radiographic evidence of periarticular ossification. Signs of loosening according to Gruen were found in 7 out of 35 patients, with no apparent clinical correlation. Surgery-related complications were noted in 15% of our 203 patients--mostly, with 10 cases each, wound infections and postoperative haematomas. In 3 cases of deep wound infection, a removal of the prosthesis was necessary, leading to a Girdlestone hip in one case. Postoperative hip dislocations occurred in 3.4% and intraoperative femur fissures were encountered in 1% of our patients. There were no cases of nerve damage or protrusion of the acetabulum reported. 43% of our patients developed a general complication--mainly cardiological or vascular problems, nephrological or urinary tract diseases, pulmonary or neurological complications. Hip arthroplasty is predominantly applied in older patients, most of them suffering from at least one medical condition at the time of surgery that influences their hospital course. This is why especially the overall physical condition of elderly patients has to be taken seriously into account when planning surgical treatment of femoral neck fractures. In our retrospective study, we have shown that implantation of a bipolar hip prosthesis constitutes an adequate treatment for these patients.

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Morbidität und Letalität bei hüftgelenknahen Femurfrakturen im höheren Lebensalter

Cited by 33 publications

References 8 publications

Welchen Einfluss hat das Implantat auf die perioperative Morbidität bei osteosynthetischer Versorgung pertrochantärer Femurfrakturen?

Welchen Einfluss hat das Implantat auf die perioperative Morbidität bei osteosynthetischer Versorgung pertrochantärer Femurfrakturen?

Perioperative Application of a Serum Protein Solution (Biseko®) After Proximal Femur Fracture of Elder Patients

Duokopfprothesenimplantation bei medialer Schenkelhalsfraktur im hohen Lebensalter – Klinische und radiologische Ergebnisse

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