Demographic and Clinical Results of Proximal Femoral Fractures

Year 2017, , 145 - 148, 15.12.2017

Alkan Albayrak , Sünkar Kaya Bayrak Altuğ Duramaz , Cemal Kızılkaya Ayten Seller Furkan Çağlayan Aslantaş

https://doi.org/10.30565/medalanya.347588

Cited By: 1

Abstract

Aim: In this study, we
aimed to evaluate the preoperative and postoperative clinical findings of the
patients who underwent surgical treatment due to proximal femoral fracture and
demographic characteristics of orthopedically traumatic inpatients in our
clinic.

Patients and Method:
This study includes all the patients who hospitalized in our clinic between the dates of 01 January and
31 December 2014. In our retrospective, cross-sectional and descriptive study;
the records of the patients were checked, and demographic and clinical data
were evaluated.

Results: A total of 3793
patients underwent surgical treatment. Of the patients who underwent surgery, 283
were operated on due to the fracture of the proximal region of the femur. The
patients mean age was 55.77 ± 29.98 years. When we investigated by age group,
94 (33.2%) patients were under 40 years old while 36 (12.7%) patients aged
40-60 years and 153 (54.1%) patients aged 60 years and over. 49.8% (141) of the
patients were male; 50.2% (142) were female. 36,7% (104) of the patients had
various additional diseases. While 91.2% (258) of the patients who were with a
clinic fracture were treated and discharged with healing, 1.8% (5) deaths were
observed. 7.1% (20) of patients were transferred to intensive care. Compared by age, in older age group ASA it is seen that scores, comorbidities, and hospitalization time increase as well as the necessity of intensive care unit.

Conclusion:
As preoperative preparations takes longer
and due to the higher level of the need for intensive care in postoperative period along with frequent comorbidities for aged patients It will be appropriate to follow these aged patients
as multidisciplinary 

Keywords

Proximal femoral fracture, inpatients, intensive care

Proksimal Femur Kırıklarında Demografik Ve Klinik Sonuçlar

Abstract

Amaç:  Bu çalışmada, kliniğimizde ortopedik travma
nedeniyle yatan hastaların demografik özellikleri ve proksimal femoral kırık
nedeniyle cerrahi tedavi uygulanan hastaların ameliyat öncesi (AÖ) ve ameliyat
sonrası (AS) klinik bulgularının değerlendirilmesi amaçlandı.

Hastalar
ve Yöntem:
Çalışmaya 01 Ocak – 31 Aralık 2014 tarihleri arasında kliniğimizde yatan tüm
hastalar dahil edildi. Retrospektif, kesitsel ve tanımlayıcı nitelikteki
çalışmamızda; hastaların kayıtları kontrol edilerek, demografik ve klinik verileri
değerlendirildi.

Bulgular: Toplam 3793 hastaya
cerrahi tedavi uygulanmıştır. Ameliyat olan hastalardan 283’ü femur proksimal
bölge kırığı nedeniyle opere olmuştur. Hastaların ortalama yaşı 55,77±29,98
yıldır. Yaşları gruplayarak incelediğimizde, 40 yaş altında 94 (%33,2) hasta;
40-60 yaş arası 36 (%12,7) hasta ve 60 yaş üzeri 153 (%54,1) hasta vardır.
Hastaların %49,8’i (141) erkek; %50,2’si (142) kadındır. Hastaların %36,7’sinde
(104) çeşitli ek hastalıklar saptanmıştır. Kliniğe kırık ile gelen hastaların %
91,2’si (258) şifa ile taburcu edilirken, %1,8 (5) ölüm gözlenmiştir.
Hastaların %7,1´(20)i yoğun bakıma devredilmiştir. İleri yaş grubunda ASA  skorlarının yükseldiği, ek hastalıkların arttığı,
hastaların postoperatif dönemde hastanede kalış sürelerinin uzadığı ve yoğun
bakım ihtiyaçlarının arttığı görülmektedir.

Sonuç: İleri yaş grubu
hastalarda ek hastalıkların sıklıkla eşlik etmesi, bu hastaların AÖ
hazırlıklarının uzun sürmesi ve AS dönemde yoğun bakım ihtiyaçlarının artması
nedeniyle bu hastaların multidisipliner olarak takip edilmesi uygun olacaktır.

Keywords

Proksimal femur kırığı, yatan hasta, yoğun bakım

References

• 1. Dimon JH, Hughston JC. Unstable intertrochanteric fractures of the hip. J Bone Joint Surg Am. 1967;49(3):440-450.
• 2. Gulberg B, Johnell O, Kanis JA. World-wide projection for hip fractures. Osteoporos Int. 1997;7(5):407-413.
• 3. Rogers FB, Shackford SR, Keller MS. Early fixation reduces morbidity and mortality in elderly patients with hip fractures from low impact falls. J Trauma. 1995;39:261-265.
• 4. Melton LJ 3rd, Kearns AE, Atkinson EJ, Bolander ME, Achenbach SJ, Huddleston JM, et al. Secular trends in hip fracture incidence and recurrence. Osteoporos Int. 2009;20(5):687-694.
• 5. Currey JD, Butler G. The mechanical properties of bone tissue in children. J Bone Joint Surg (Am). 1975;57:810-814.
• 6. Koren L, Barak A, Norman D, Sachs O, Peled E. Effect of Seasonality, Weather and Holidays on the Incidence of Proximal Hip Fracture. IMAJ 2014;16:299–302 .
• 7. Chang CH, Jiang CC. Evaluation of critical postoperative situations in orthopedic patients. J Formos Med Assoc. 1997:96:990-995.
• 8. Freeman MAR, Todd RC, Pirie CJ. The role of fatigue in the pathogenesis of senile femoral neck fractures. J Bone Joint Surg Br. 1974;56:698-702. 9. Miyasaka D, Endo N, Endo E, Sakuma M, Yamamoto N, Tanabe N. et al. Incidence of hip fracture in Niigata, Japan in 2004 and 2010 and the longterm trends from 1985 to 2010. J Bone Miner Metab. 2016;34(1):92-98.
• 10. Daniachi D, Netto AS, Ono NK, Guimarães RP, Polesello GC, Honda EK. Epidemiology of fractures of the proximal third of the femur in elderly patients. Rev Bras Ortop. 2015;50(4):371–377.
• 11. Rosenthal GE, Sirio CA, Shepardson LB, Harper DL, Rotondi AJ, Cooper GS. Use of intensive care units for patients with low severity of illness. Arch Intern Med. 1998;158:1144-1151.
• 12. Giannoudis PV. Aspects of current management: Surgical priorities in damage kontrol in polytrauma. Br J Bone Joint Surg. 2003;85:478-483. 13. Zeyneloğlu P, Pirat A, Candan S, Canikli Ş, Erkaya Ç, Karaeminoğulları O. et al. Kalça protezi cerrahisi yapılan geriatrik hastaların yoğun bakım ünitesine kabul ön belirleyicileri. Yoğun Bakım Dergisi. 2006;6(2):108-112. 14. Michel JP, Klopfenstein C, Hoffmeyer P, Stern R, Grab B. Hip fracture surgery: Is the preoperative American Society of Anesthesiologists (ASA) score a predictor of functional outcome? Aging Clin Exp Res. 2002;14(5):389-394.
• 15. Daabiss M. American Society of Anaesthesiologists physical status classification. Indian Journal of Anaesthesia. 2011;55(2):111-115.
• 16. Forrest GP, Roque JM, Dawodu ST. Decreasing length of stay after total joint arthroplasty: Effect on referrals to rehabilitation units. Arch Phys Med Rehabil. 1999;80:192-194.
• 17. Gamio JC, Harnish R, Saeed I, Streeper T, Sigurdsson S, Amin S. et al. Structural patterns of the proximal femur in relation to age and hip fracture risk in women. Bone. 2013;57(1):290-299. 18. Metcalfe D, Salim A, Olufajo O, Gabbe B, Zogg C, Harris MB. et al. Hospital case volume and outcomes for proximal femoral fractures in the USA: an observational study. BMJ Open. 2016;6: e010743.doi:10.1136/ bmjopen-2015-010743