Proximale Femurfrakturen im Alter

Frerichmann, U.; Raschke, MJ; Stöckle, Ulrich; Wöhrmann, S; Lohmann, R

doi:10.1007/s00113-007-1258-y

Cited by 43 publications

(16 citation statements)

References 36 publications

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“…In Germany, a rise of 74% in the incidence of proximal femoral fractures until the year 2020 is forecasted [2]. In the same study, a current in-hospital mortality of 8.6% was described in over 85 year old patients.…”

Section: Introductionmentioning

confidence: 93%

“…The incidence of hip fractures related to osteoporosis is steadily increasing [1,2]. In Germany, a rise of 74% in the incidence of proximal femoral fractures until the year 2020 is forecasted [2].…”

Section: Introductionmentioning

confidence: 99%

“…In the same study, a current in-hospital mortality of 8.6% was described in over 85 year old patients. The morbidity and mortality after this kind of fracture is thereby high [2,3]. The risk factors for mortality include the development of one or more postoperative complications [4].…”

Section: Introductionmentioning

confidence: 99%

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Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

Renken

Paech

et al. 2012

BMC Musculoskelet Disord

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BackgroundA minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma.MethodsSixty patients who sustained a fractured neck of femur were randomly assigned into two groups. In the minimal invasive arm, the so called “direct anterior approach” (DAA) was chosen, in the conventional arm the Watson-Jones-Approach was used for implantation of a bipolar hemi-arthroplasty.Primary outcome parameter was the mobility as measured by the four-item-Barthel index. Secondary outcome parameters included pain, haemoglobin-levels, complications, duration of surgery, administration of blood transfusion and external length of incision. Radiographs were evaluated.ResultsA statistically significant difference (p = 0,009) regarding the mobility as measured with the four-item Barthel index was found at the 5th postoperative day, favouring the DAA. Evaluation of the intensity of pain with a visual analogue scale (VAS) showed a statistically significant difference (p = 0,035) at day 16. No difference was evident in the comparison of radiographic results.ConclusionsComparing two different approaches to the hip joint for the implantation of a bipolar hemi-arthroplasty after fractured neck of femur, it can be stated that mobilization status is improved for the DAA compared to the WJA when measured by the four-item Barthel index, there is less pain as measured using the VAS. There is no radiographic evidence that a minimal invasive technique leads to inferior implant position.Level of Evidence: Level II therapeutic study.

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Section: Introductionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

Renken

Paech

et al. 2012

BMC Musculoskelet Disord

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“…Osteoporosis treatment with drugs initiated after a proximal femoral fracture is accompanied by a significant reduction in new fractures and optimised survival [18]. The Working Group Geriatric Traumatology of the German Society for Trauma Surgery (AG Alterstraumatologie der Deutschen Gesellschaft für Unfallchirurgie) predicts that the number of proximal femoral fractures will rise dramatically by 351% by 2050 due to demographic development [19]. This estimate underlines the importance of ascertaining the diagnosis for osteoporosis mentioned above.…”

Section: Methodsmentioning

confidence: 99%

Investigation and management of osteoporosis in aged trauma patients: a treatment algorithm adapted to the German guidelines for osteoporosis

et al. 2017

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BackgroundOsteoporosis-associated fractures are of increasing importance in trauma surgery. Systematic diagnostics and treatment of osteoporosis during a hospital stay, however, remain inadequate. Therefore, a specific algorithm for diagnosing and treating osteoporosis in trauma surgery patients was developed based on the DVO (German Osteology Society) guideline for osteoporosis from 2014.MethodsIn a first step, the individuals’ age and risk profile for osteoporosis is identified considering specific fractures indicating osteoporosis and risk factors assessed by a specific questionnaire. In addition, physical activity, risk of falls, dietary habits and the individuals’ medication are considered. Basic osteoporosis laboratory tests, a bone densitometry by dual-energy X-ray absorptiometry (DXA) and, if needed, X-rays of the spine are carried out to identify prevalent vertebral body fractures.ResultsBased on the treatment algorithm adapted to the new guidelines for osteoporosis in the majority of proximal femoral fractures, treatment of osteoporosis could already be indicated without prior DXA. In case of preexisting glucocorticoid therapy, a history of previous fractures or other risk factors according to the risk questionnaire, the threshold of treatment has to be adjusted given the table of T-scores.ConclusionsThe treatment algorithm for diagnosing and treating osteoporosis in in-patient trauma surgery patients can help identify high-risk patients systematically and efficiently. As a result, osteoporosis-associated fractures or failure of osteosynthesis could be reduced, yet a prospective validation of the algorithm has to be completed.

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“…Die Versorgung dieser Fraktur gehört zur "Brotund Butterchirurgie" mittlerer Krankenhäuser mit Bettengrößen zwischen 150 und 600 Betten. Hier werden heutzutage 70 % der betroffenen Patienten versorgt [5]. Obwohl es sich bei den Patienten um überwiegend alte und vorerkrankte Patienten handelt, eignet sich die Nagelung dieser Frakturen aufgrund der hohen Standardisierung des Eingriffes prinzipiell gut als Ausbildungseingriff [6].…”

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Pertrochantäre Femurfraktur – Technik und eigene Ergebnisse

Chmielnicki

Prokop

2015

Z Orthop Unfall

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Proximale Femurfrakturen im Alter

Abstract: There was a significant age-dependent increase of acute hospital mortality with a maximum of 8.6% in the group of the patients older than 85 years. As a result of the demographic change fracture rates in the elderly population will rise significantly.

Cited by 43 publications

References 36 publications

Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

Investigation and management of osteoporosis in aged trauma patients: a treatment algorithm adapted to the German guidelines for osteoporosis

Pertrochantäre Femurfraktur – Technik und eigene Ergebnisse

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