ABSTRACT
OBJECTIVES: The purpose of the study was to assess the effectiveness of the Fracture Liaison service (FLS) in preventing secondary fracture and decreasing 1-year mortality rate after osteoporotic hip fracture, in patients at Police General Hospital, Bangkok, Thailand. METHODS: A prospective cohort study was conducted. We studied male and female patients, 50 years of age and older, who presented with a fragility fracture around the hip due to low energy trauma and were admitted to Police General Hospital, participating in PGH's Liaison service from April 1, 2014-March 30, 2015. The sample size was 75 patients, with a follow up time of 1 year. The data from this study was compared with that of a previous study done by Tanawat A. et al. [9] prior to commencement of the FLS project. RESULTS: After a follow up period of 1 year, the mortality rate was measured to be 10.7% and there was no evidence of secondary fragility fracture. Post-injury bone mineral density follow up and osteoporotic medication treatment rates were 48% and 80%, respectively. Patients who participated in the project were found to have a decreasing rate of secondary fracture from 30% to 0% (P < 0.0001), an increasing post-injury BMD follow up rate from 28.3% to 48% (P = 0.0053), and an increase in post-injury osteoporotic medication administration rate from 40.8% to 80% (P = 0.0148), all with statistical significance. However, the 1-year mortality rate was not significant (P = 0.731) when compared to the previous study. CONCLUSIONS: Patients with recent hip fractures participating in the Fracture Liaison service had a significantly higher post-injury BMD follow up and osteoporotic medication administration rates. This resulted in a lower risk of secondary fracture than those who did not participate in the Fracture Liaison service at a follow up time of one year.
ABSTRACT
OBJECTIVE: To determine the efficacy of the Percutaneous K-wire for Acromio-clavicular joint separation type III. MATERIAL AND METHOD: A retrospective chart review of patients who underwent AC joint separation type III by the interested technique during 1993-2009 at department of orthopaedic, Police General Hospital, was done. Only patients with sufficient data recorded were included in the analysis. These patients were placed in the lateral decubital position under general anesthesia. Percutaneous K-wire fixation started after the dislocated AC-joint had been closely reduced under image-intensifier control. Two K-wires (2.0 mm) were inserted into the prominent part of acromial process or scapular spine into the distal clavicle. Post-operative sling was subsequently used to limit the heavy duty. RESULTS: Twenty-one patients were included in the analysis, with the mean follow-up duration of 19 weeks (4-135). Painless at full range of shoulder motion was obtained in twenty patients There was only one patient had limitation of abduction (150 degrees abduction). The mean Neer's shoulder score was 94.25 points (50-100). Only 3 cases had unsatisfied outcomes results during the study period. CONCLUSION: The percutaneous K-wire fixation for the AC-joint Separation was found to be efficacious and safe at an economical cost.
