Unipolar Hip Hemiarthroplasty in Geriatric Patients: A Prospective Study and Analysis of Clinical and Radiological Outcomes.

Introduction: Femoral neck fractures (FNF) in the geriatric population are commonly treated with hip replacement procedures, such as total hip arthroplasty, unipolar hip hemiarthroplasty (UHA), and bipolar hip hemiarthroplasty (BHA). The optimal treatment remains controversial, considering outcomes and cost-effectiveness, with UHA often being cheaper. This prospective observational study aims to evaluate UHA's clinical and radiological outcomes, safety, and survivorship compared to existing literature. Methods: We followed 90 elderly patients who underwent UHA following FNF. We assessed patients using the Parker score before and after surgery, as well as Harris Hip Score (HHS), and Postel-Merle d'Aubigné (PMA) scores postoperatively. All complications, acetabular erosions and heterotopic ossifications (HO), were documented. Results: One year post-surgery, 26.7% of patients had passed away, mostly due to declining general health status. Systemic complications occurred in 14.4% of cases, with a 1.1% rate of deep surgical site infections. A single dislocation resulted from excessive stem anteversion. UHA implant survival rate was 97.8% after 4 years. The Parker score remained stable, and HHS at 6 and 12 months was 71.5 ± 12.9 and 70.9 ± 11.8, respectively, while PMA score was 14.3 ± 2.4 and 14.5 ± 2.1, respectively. Five hips showed Baker I acetabular wear. HO were noted as Brooker I in 12 patients, II in 4 patients, and IV in 1 patient. Discussion: UHA exhibited comparable systemic complication rates, implant survivorship, and dislocation rates to those in the literature for both UHA and BHA. The deep surgical site infection rate was lower than reported for BHA. Patients' functional and mental abilities did not decline based on clinical scores. Acetabular wear in UHA was similar to its bipolar counterpart, while HO were only minor findings with no clinical implications. Conclusion: In elderly patients, UHA demonstrated clinical and radiological outcomes similar to BHA in existing literature. UHA may represent a cost-effective alternative for patients with limited life expectancy.

Radiologic, clinical, and functional evaluation of children with lateral humeral condyle fractures using the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire.

This study investigated the clinical and radiologic outcomes of lateral humeral condyle (LHC) fractures in children and evaluated the functional outcome of these injuries according to the type of treatment using the Quick DASH questionnaire. Data on consecutive children admitted to the Emergency Department for LHC fracture (01/11-12/18) were collected from their charts. Anterior-posterior and lateral radiographs of the injured elbow were used to classify each fracture according to Jakob's classification, and to detect any other concomitant bone lesions. Data on pain, stiffness, impact on daily activities, skin lesions, surgical-site infection, and range of motion were retrieved. The Quick DASH questionnaire was used to evaluate functional outcome. Forty-eight children with a mean age at trauma of 6.06 ± 2.22 years (32 males; mean follow-up: 75 ± 25 months) were reviewed. The overall Quick DASH score was 4 (0-15.9); it was 2.69 ± 0.31 in Jakob-1 ( n = 12; 25%), 3 ± 1.06 in Jakob-2 ( n = 19; 39.6%), and 3.06 ± 1.56 in Jakob-3 fractures ( n = 17; 35.4%). Functional outcomes were similar irrespective of the severity of displacement, type of treatment, length of postoperative immobilization, and presence of associated fracture ( P > 0.05). Quick DASH scores in children less than 8 years (2.77 ± 0.44) and in those more than 8 years (3.47 ± 2.13) were similar ( P > 0.05). Five out of 48 patients developed one complication (10.5%). Good functional and radiologic outcomes can be expected in children with LHC fractures irrespective of the amount of initial displacement, type of treatment, length of postoperative immobilization, and age at surgery. Families should be warned about potential complications although these are most often minor. Level of evidence: III.

Pattern of orthopedic injuries among Victims of Road Traffic Accidents in Aseer region, Saudi Arabia.

BACKGROUND: Road Traffic Accidents (RTA) are one of the most common causes of morbidity and mortality in Saudi Arabia despite preventive measures and programs. The major factors for the increase in the incidence of mortality and morbidity are due to human factors, such as over speeding, not obeying traffic laws, fatigue, and driving before the legal age. In this study, we aim to report the pattern of orthopedic injuries (OIs) from RTA in the south-western region of Saudi Arabia and to explore the healthcare outcomes of OIs. METHOD: This is a retrospective, record-based, case series study including RTA patients who were admitted to the Emergency Department (ED) at a tertiary hospital in the south-western region of Saudi Arabia. The data was collected for 531 admitted RTA patients with OIs over for five years from May 2011 to May 2016. Patients who were 15 years of age or above were included in this study. The data were analyzed using the statistical package for social science (SPSS) version 21. RESULTS: A total of 531 patients were included with an age range between 15 and 90 years with an average age of 29 ± 2 years. Most of the population was male constituting 91.3% of the sample while 91.9% of the sample were Saudis. About 75% of the OIs had simple fractures and complex fractures were recorded among 10.2% of the cases. About half of the cases (52%) had lower limb fractures and 32% had upper limb fractures. CONCLUSIONS: RTA and the resultant OIs, death, and permanent disabilities cause a tremendous burden on economic resources and should be of concern for local authorities. More attention and regularities should be paid to avoid life-threatening driving behaviors.