RESUMO
The incidence of total knee arthroplasty (TKA) is increasing, as are periprosthetic supracondylar femoral fractures. Treatment is complex and may involve the use of a retrograde intramedullary femoral nail, and it is essential to know the nail will fit through the femoral prosthesis in line with the intramedullary canal. Knowledge of certain measurements is crucial i.e. minimal intercondylar distance and the position of the notch on the femoral component in relation to the intramedullary canal. A review of TKA prostheses dimensions and their compatibility with a retrograde nail was obtained directly from the manufacturers. A comprehensive data set lists manufacturer, model, size, minimal intercondylar notch distance and position. This will be of practical use when planning the operative management of periprosthetic supracondylar femoral fractures.
Assuntos
Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/estatística & dados numéricos , Fraturas do Fêmur/epidemiologia , Fraturas do Fêmur/cirurgia , Fraturas Periprotéticas/epidemiologia , Fraturas Periprotéticas/cirurgia , Pinos Ortopédicos , Humanos , Incidência , Reoperação/métodosRESUMO
Preparing elderly patients for emergency hip fracture surgery is a significant challenge for hospital staff. This article discusses the principles of preoperative care in these patients, and the rationale for such strategies, based on evidence and current guidelines. Such guidance increasingly reflects a national standard of care.
Assuntos
Emergências , Fraturas do Quadril/cirurgia , Assistência Perioperatória/métodos , Idoso , Idoso de 80 Anos ou mais , Analgesia/métodos , Transfusão de Sangue , Hidratação/métodos , Avaliação Geriátrica/métodos , Humanos , Consentimento Livre e Esclarecido , Pessoa de Meia-Idade , Oxigenoterapia/métodos , Guias de Prática Clínica como Assunto , Trombose/prevenção & controle , Fatores de TempoRESUMO
The role of total hip arthroplasty (THA) for fracture in octogenarians remains unclear. Over a two-year period, 354 patients aged > 80 years were admitted with a displaced intracapsular hip fracture. Using defined clinical guidelines, 38 patients underwent THA with a median age of 84 years, mean follow-up of 20 months. Primary outcomes were dislocation, 30-day and one-year mortality, revision surgery and periprosthetic fracture. There were no dislocations or periprosthetic fractures and patient survival was 97% at 30 days and 87% at one year. There was one revision for deep infection. This study demonstrates that THA for selected octogenarians can be performed safely, allows the majority of patients to return to independent living and has a low complication rate.