Development of Fear of Falling after proximal femoral fracture.

Background: Proximal femoral fracture is common in older people. Beyond a long recovery process and significant permanent functional limitations, older people often experience subsequent Fear of Falling. The phenomenon of Fear of Falling is not fully understood; qualitative research is underrepresented but can provide insights into the experience of those affected. Objectives: We aimed to explore the experiences of Fear of Falling development and to what extent it affects peoples' life after proximal femoral fracture. Methods: We conducted semi-structured, in-depth interviews with nine older people, aged between 61 and 88, who participated in a prospective observational study. Interview data were analysed through inductive content analysis. Results: Six major themes emerged: The development of Fear of Falling; the effect of FoF and hope for recovery; alternating between moments of fear and security; fear of helplessness and of losing independence; strategies for dealing with Fear of Falling and maintaining independence; need of support by health care professionals. Conclusion: To identify and support older people in coping with Fear of Falling (after proximal femoral fracture), strategies for dealing with Fear of Falling across occupational groups and all healthcare settings should be implemented. Nurses have a key role in this process.

[Knee pain of unknown origin after total knee prosthesis in a patient with chronic polyarthritis]. / Unklare Knieschmerzen nach Knie-Totalprothese bei einem Patienten mit chronischer Polyarthritis.

Persisting pain after TKA is a frequent problem. The most frequent differential diagnoses are aseptic loosening, malpositioning or a prosthetic joint infection. Retropatellar pain, functional or psychosomatic cause should be taken into account, too. An acute episode in patients with a rheumatoid arthritis should be ruled out. Insufficiency fractures, which can also be found in the presented case, are more often in patients with rheumatoid arthritis. The insufficiency fracture was detectable in the MRI and shows an uncommon, non-described localization. To prevent a loss of mobility of fractures close to the joint a surgical stabilizing is recommended, leading to quick healing.