¿Ha influido el confinamiento social por COVID-19 en la mortalidad de la fractura de cadera? Análisis de la mortalidad al año / Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality

Introducción y objetivos: El objetivo principal de este estudio es analizar la mortalidad al año en los pacientes con fractura intracapsular de cadera que ingresaron durante un severo confinamiento social en los primeros meses de la pandemia por COVID-19 y compararla con años previos. Material y método: Estudio observacional retrospectivo en el que se comparó una cohorte del 14 marzo al 21 de junio de 2020 (grupo pandemia, n = 62) con una cohorte control en las mismas fechas de los años 2017, 2018 y 2019 (grupo control, n = 172). Se midieron la mortalidad a los 30 días y al año, complicaciones ortopédicas, grado ASA, comorbilidades, diagnóstico y tratamiento, tiempo hasta cirugía y estancia hospitalaria. Resultados: No se encontraron diferencias significativas en la mortalidad a los 30 días (p = 0,156; 9,7% vs. 4,7%) ni en la mortalidad anual (p = 0,47) entre el grupo pandemia (21%) y el control (16,9%). Se objetivó un descenso de la demora quirúrgica y de la estancia media en el grupo pandemia, aunque sin significación estadística. Conclusión: El estado de alarma modificó la distribución del tipo de fractura de cadera con un predominio de la fractura intracapsular. Mantener el mismo manejo hospitalario que previo a la pandemia permitió no incrementar la mortalidad a los 30 días y al año en los pacientes con fractura intracapsular de cadera.(AU)

Introduction and objectives: The main objective of this study is to analyze the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. Material and methods: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n = 62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n = 172). Thirty-day-mortality and one-year-mortality, orthopedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. Results: No significant differences were found in 30-day mortality (p = 0.156; 9.7% compared to 4.7%) or in one-year mortality (p = 0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. Conclusión: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.(AU)

[Translated article] Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality / ¿Ha influido el confinamiento social por COVID-19 en la mortalidad de la fractura de cadera? Análisis de la mortalidad al año

Introducción y objetivos: El objetivo principal de este estudio es analizar la mortalidad al año en los pacientes con fractura intracapsular de cadera que ingresaron durante un severo confinamiento social en los primeros meses de la pandemia por COVID-19 y compararla con años previos. Material y método: Estudio observacional retrospectivo en el que se comparó una cohorte del 14 marzo al 21 de junio de 2020 (grupo pandemia, n = 62) con una cohorte control en las mismas fechas de los años 2017, 2018 y 2019 (grupo control, n = 172). Se midieron la mortalidad a los 30 días y al año, complicaciones ortopédicas, grado ASA, comorbilidades, diagnóstico y tratamiento, tiempo hasta cirugía y estancia hospitalaria. Resultados: No se encontraron diferencias significativas en la mortalidad a los 30 días (p = 0,156; 9,7% vs. 4,7%) ni en la mortalidad anual (p = 0,47) entre el grupo pandemia (21%) y el control (16,9%). Se objetivó un descenso de la demora quirúrgica y de la estancia media en el grupo pandemia, aunque sin significación estadística. Conclusión: El estado de alarma modificó la distribución del tipo de fractura de cadera con un predominio de la fractura intracapsular. Mantener el mismo manejo hospitalario que previo a la pandemia permitió no incrementar la mortalidad a los 30 días y al año en los pacientes con fractura intracapsular de cadera.(AU)

Introduction and objectives: The main objective of this study is to analyze the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. Material and methods: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n = 62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n = 172). Thirty-day-mortality and one-year-mortality, orthopedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. Results: No significant differences were found in 30-day mortality (p = 0.156; 9.7% compared to 4.7%) or in one-year mortality (p = 0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. Conclusión: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.(AU)

Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality. / ¿Ha influido el confinamiento social por COVID-19 en la mortalidad de la fractura de cadera? Análisis de la mortalidad al año.

INTRODUCTION AND OBJECTIVES: The main objective of this study is to analyze the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. MATERIAL AND METHODS: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n = 62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n = 172). Thirty-day-mortality and one-year-mortality, orthopedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. RESULTS: No significant differences were found in 30-day mortality (p = 0.156; 9.7% compared to 4.7%) or in one-year mortality (p = 0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. CONCLUSIóN: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.

[Translated article] Has the COVID-19 lockdown influenced the mortality of hip fracture? Analysis of one-year mortality.

INTRODUCTION AND OBJECTIVES: The main objective of this study is to analyse the one-year mortality in patients with intracapsular hip fracture who were admitted during severe social confinement in the first months of the COVID-19 lockdown and compare it with previous years. MATERIAL AND METHODS: Retrospective observational study in which a cohort from March 14 to June 21, 2020 (pandemic group, n=62) was compared with a control cohort on the same dates in the years 2017, 2018 and 2019 (control group, n=172). Thirty-day-mortality and one-year-mortality, orthopaedic complications, ASA grade, comorbidities, diagnosis and treatment, time to surgery and mean stay were measured. RESULTS: No significant differences were found in 30-day mortality (p=0.156; 9.7% compared to 4.7%) or in one-year mortality (p=0.47) between the pandemic group (21%) and the control one (16.9%). A decrease in surgical delay and mean stay was observed in the pandemic group, although without statistical significance. CONCLUSION: The State of Alarm modified the distribution of the type of hip fracture with a predominance of intracapsular fracture. Maintaining the same hospital management as prior to the pandemic period made it possible not to increase 30-day mortality and one-year mortality in patients with intracapsular hip fracture.

Prospective study about orthopaedic treatment of fifth metacarpal neck fractures. / Estudio prospectivo sobre el tratamiento conservador de las fracturas de cuello de quinto metacarpiano.

INTRODUCTION: The fifth metacarpal neck fracture is traditionally treated with closed reduction and intrinsic plus cast immobilization. Another alternative and more functional treatment is the syndactylia. The aim of our study is to compare both treatments searching for any differences in their functional outcomes. METHOD: We did a prospective, controlled, masked, randomized cohort study with patients over 18 years old attended from May 2019 to May 2020 in Vigo's Sanitary Area with this injure and an angle below 40°. The collected data was: sex, age, fracture angle, range of motion of the metacarpophalangeal articulation (MCFA), grip strength, pain, fracture consolidation, Quick DASH and comfort 4 and 6 weeks after the injury. RESULTS: 39 men and 1 woman were included in the sample. 36.1 years old as the age average. 90% of the injuries affected the right hand, being all the patients right-handed, finding statistically significant differences in MCFA flexion within 4 weeks and in grade of discomfort, both in favour of the syndactylia (p<0.05). Any of the other collected data was statistically significant. Every fracture achieved consolidation at the end of the follow-up. CONCLUSION: Following the results, we consider both immobilizations good treatment options of these fractures; nevertheless, syndactylia has proven an earlier MCFA flexion recovery and a better tolerance.

Estudio prospectivo sobre el tratamiento conservador de las fracturas de cuello de quinto metacarpiano / Prospective study about orthopaedic treatment of fifth metacarpal neck fractures

Introducción: La fractura de cuello del quinto metacarpiano se trata tradicionalmente mediante la reducción cerrada e inmovilización con férula en intrínseco plus. Una alternativa es el tratamiento funcional mediante sindactilia. Nuestro objetivo es comparar ambos tratamientos buscando diferencias de resultado funcional entre ambas opciones. Método: Realizamos un estudio de cohortes prospectivo, controlado, enmascarado y aleatorizado con pacientes mayores de 18años con esta lesión y angulación<40°, atendidos entre mayo de 2019 y mayo de 2020 en el Área Sanitaria de Vigo. Se recogieron las variables: sexo, edad, lado, angulación de la fractura, movilidad de la articulación metacarpofalángica (MCF), fuerza de prensión, dolor, consolidación de la fractura, Quick DASH y grado de satisfacción y confort. Esta información fue recogida a las 4 y a las 6 semanas. Resultados: La muestra constó de 39 hombres y una mujer. La edad media fue de 36,1años. El 90% afectó a la mano derecha siendo todos los pacientes diestros, encontrando diferencias estadísticamente significativas en la flexión de la articulación MCF a las 4 semanas y en el grado de molestia de la inmovilización, ambos en favor de la sindactilia (p<0,05). El resto de variables recogidas no mostraron significación estadística. En todos los pacientes se consiguió la consolidación de la fractura. Conclusión: A raíz de los resultados obtenidos, consideramos que ambas inmovilizaciones pueden utilizarse en el tratamiento de estas fracturas; sin embargo, la sindactilia demuestra una movilidad en flexión de la articulación MCF más temprana y mejor tolerancia.(AU)

Introduction: The fifth metacarpal neck fracture is traditionally treated with closed reduction and intrinsic plus cast immobilization. Another alternative and more functional treatment is the syndactylia. The aim of our study is to compare both treatments searching for any differences in their functional outcomes. Method: We did a prospective, controlled, masked, randomized cohort study with patients over 18 years old attended from May 2019 to May 2020 in Vigo's Sanitary Area with this injure and an angle below 40°. The collected data was: sex, age, fracture angle, range of motion of the metacarpophalangeal articulation (MCFA), grip strength, pain, fracture consolidation, Quick DASH and comfort 4 and 6 weeks after the injury. Results: 39 men and 1 woman were included in the sample. 36.1 years old as the age average. 90% of the injuries affected the right hand, being all the patients right-handed, finding statistically significant differences in MCFA flexion within 4 weeks and in grade of discomfort, both in favour of the syndactylia (p<0.05). Any of the other collected data was statistically significant. Every fracture achieved consolidation at the end of the follow-up. Conclusion: Following the results, we consider both immobilizations good treatment options of these fractures; nevertheless, syndactylia has proven an earlier MCFA flexion recovery and a better tolerance.(AU)

Prospective study about orthopaedic treatment of fifth metacarpal neck fractures / Estudio prospectivo sobre el tratamiento conservador de las fracturas de cuello de quinto metacarpiano

Introduction: The fifth metacarpal neck fracture is traditionally treated with closed reduction and intrinsic plus cast immobilization. Another alternative and more functional treatment is the syndactylia. The aim of our study is to compare both treatments searching for any differences in their functional outcomes. Method: We did a prospective, controlled, masked, randomized cohort study with patients over 18 years old attended from May 2019 to May 2020 in Vigo's Sanitary Area with this injure and an angle below 40°. The collected data was: sex, age, fracture angle, range of motion of the metacarpophalangeal articulation (MCFA), grip strength, pain, fracture consolidation, Quick DASH and comfort 4 and 6 weeks after the injury. Results: 39 men and 1 woman were included in the sample. 36.1 years old as the age average. 90% of the injuries affected the right hand, being all the patients right-handed, finding statistically significant differences in MCFA flexion within 4 weeks and in grade of discomfort, both in favour of the syndactylia (p<0.05). Any of the other collected data was statistically significant. Every fracture achieved consolidation at the end of the follow-up. Conclusion: Following the results, we consider both immobilizations good treatment options of these fractures; nevertheless, syndactylia has proven an earlier MCFA flexion recovery and a better tolerance.(AU)

Introducción: La fractura de cuello del quinto metacarpiano se trata tradicionalmente mediante la reducción cerrada e inmovilización con férula en intrínseco plus. Una alternativa es el tratamiento funcional mediante sindactilia. Nuestro objetivo es comparar ambos tratamientos buscando diferencias de resultado funcional entre ambas opciones. Método: Realizamos un estudio de cohortes prospectivo, controlado, enmascarado y aleatorizado con pacientes mayores de 18años con esta lesión y angulación<40°, atendidos entre mayo de 2019 y mayo de 2020 en el Área Sanitaria de Vigo. Se recogieron las variables: sexo, edad, lado, angulación de la fractura, movilidad de la articulación metacarpofalángica (MCF), fuerza de prensión, dolor, consolidación de la fractura, Quick DASH y grado de satisfacción y confort. Esta información fue recogida a las 4 y a las 6 semanas. Resultados: La muestra constó de 39 hombres y una mujer. La edad media fue de 36,1años. El 90% afectó a la mano derecha siendo todos los pacientes diestros, encontrando diferencias estadísticamente significativas en la flexión de la articulación MCF a las 4 semanas y en el grado de molestia de la inmovilización, ambos en favor de la sindactilia (p<0,05). El resto de variables recogidas no mostraron significación estadística. En todos los pacientes se consiguió la consolidación de la fractura. Conclusión: A raíz de los resultados obtenidos, consideramos que ambas inmovilizaciones pueden utilizarse en el tratamiento de estas fracturas; sin embargo, la sindactilia demuestra una movilidad en flexión de la articulación MCF más temprana y mejor tolerancia.(AU)

Influence of integrated orthogeriatric care on morbidity and mortality and length of hospital stay for hip fracture / Influencia de la atención ortogeriátrica integrada en la morbimortalidad y el tiempo de estancia hospitalaria de la fractura de cadera

Background and objectives: Compare the morbidity and mortality, the length of hospital stay and the economic cost of the fragility fracture of the hip, in two nonconsecutive years thanks to the integrated orthogeriatric care. Material and method: Retrospective observational cohort study with 633 patients with hip fragility fracture with a mean age of 85.5 years, treated in the same Trauma and Orthopaedic Surgery service in two different years (2012 and 2017). Mean stay, surgical delay, perioperative mortality, one month and one year, and perioperative complications such as acute urine retention, pressure ulcers, and need for transfusion were measured. Results: Mortality during admission decreased from 10% in 2012 to 3.6% in 2017 (P=.004 *), while mortality at thirty days (10.5% vs 7%) (P=.123) and one year (28.9% versus 24.9%) (P=.277). Hospital stay times, surgical delay, and postoperative admission time also decreased. The estimated total annual economic savings thanks to integrated orthogeriatric care amounted to €1,017,084.94. Conclusions: Integrated orthogeriatric care of the patient with fragility fracture of the hip, results in a more effective and efficient care model. Both the care and the clinical situation of patients are improved in the perioperative period, both hospital stay and mortality during admission are significantly reduced, and all this with significant associated economic savings.(AU)

Antecedentes y objetivos: Comparar la morbimortalidad, el tiempo de estancia hospitalaria y el gasto económico de la fractura por fragilidad de cadera en 2 años no consecutivos gracias a la atención ortogeriátrica integrada. Material y método: Estudio observacional retrospectivo de cohorte con 633 pacientes con fractura por fragilidad de cadera, con una media de edad de 85,5 años, tratados en un mismo servicio de cirugía ortopédica y traumatología en 2 años diferentes (2012 y 2017). Se midieron la estancia media, la demora quirúrgica, la mortalidad perioperatoria, al mes y al año, y las complicaciones perioperatorias como la retención aguda de orina, las úlceras por presión y la necesidad de transfusión. Resultados: La mortalidad durante el ingreso disminuyó del 10% en 2012 al 3,6% en 2017 (p=0,004), a la vez que la mortalidad a los 30 días (10,5% frente a 7%) (p=0,123) y al año (28,9% frente a 24,9%) (p=0,277). También disminuyeron los tiempos de estancia hospitalaria, la demora quirúrgica y el tiempo de ingreso postoperatorio. El ahorro económico total anual estimado gracias a la atención ortogeriátrica integrada supuso 1.017.084,94€. Conclusiones: La atención ortogeriátrica integrada del paciente con fractura por fragilidad de la cadera resulta en un modelo de atención más efectivo y eficiente. Se mejora tanto la calidad asistencial como la situación clínica de los pacientes en el periodo perioperatorio, se disminuyen significativamente tanto la estancia hospitalaria como la mortalidad durante el ingreso, y todo ello con un importante ahorro económico asociado.(AU)

Influencia de la atención ortogeriátrica integrada en la morbimortalidad y el tiempo de estancia hospitalaria de la fractura de cadera / Influence of integrated orthogeriatric care on morbidity and mortality and length of hospital stay for hip fracture

Antecedentes y objetivos: Comparar la morbimortalidad, el tiempo de estancia hospitalaria y el gasto económico de la fractura por fragilidad de cadera en 2 años no consecutivos gracias a la atención ortogeriátrica integrada. Material y método: Estudio observacional retrospectivo de cohorte con 633 pacientes con fractura por fragilidad de cadera, con una media de edad de 85,5 años, tratados en un mismo servicio de cirugía ortopédica y traumatología en 2 años diferentes (2012 y 2017). Se midieron la estancia media, la demora quirúrgica, la mortalidad perioperatoria, al mes y al año, y las complicaciones perioperatorias como la retención aguda de orina, las úlceras por presión y la necesidad de transfusión. Resultados: La mortalidad durante el ingreso disminuyó del 10% en 2012 al 3,6% en 2017 (p=0,004), a la vez que la mortalidad a los 30 días (10,5% frente a 7%) (p=0,123) y al año (28,9% frente a 24,9%) (p=0,277). También disminuyeron los tiempos de estancia hospitalaria, la demora quirúrgica y el tiempo de ingreso postoperatorio. El ahorro económico total anual estimado gracias a la atención ortogeriátrica integrada supuso 1.017.084,94€. Conclusiones: La atención ortogeriátrica integrada del paciente con fractura por fragilidad de la cadera resulta en un modelo de atención más efectivo y eficiente. Se mejora tanto la calidad asistencial como la situación clínica de los pacientes en el periodo perioperatorio, se disminuyen significativamente tanto la estancia hospitalaria como la mortalidad durante el ingreso, y todo ello con un importante ahorro económico asociado.(AU)

Background and objectives: Compare the morbidity and mortality, the length of hospital stay and the economic cost of the fragility fracture of the hip, in two nonconsecutive years thanks to the integrated orthogeriatric care. Material and method: Retrospective observational cohort study with 633 patients with hip fragility fracture with a mean age of 85.5 years, treated in the same Trauma and Orthopaedic Surgery service in two different years (2012 and 2017). Mean stay, surgical delay, perioperative mortality, one month and one year, and perioperative complications such as acute urine retention, pressure ulcers, and need for transfusion were measured. Results: Mortality during admission decreased from 10% in 2012 to 3.6% in 2017 (P=.004 *), while mortality at thirty days (10.5% vs 7%) (P=.123) and one year (28.9% versus 24.9%) (P=.277). Hospital stay times, surgical delay, and postoperative admission time also decreased. The estimated total annual economic savings thanks to integrated orthogeriatric care amounted to €1,017,084.94. Conclusions: Integrated orthogeriatric care of the patient with fragility fracture of the hip, results in a more effective and efficient care model. Both the care and the clinical situation of patients are improved in the perioperative period, both hospital stay and mortality during admission are significantly reduced, and all this with significant associated economic savings.(AU)

Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo / Epidemiological study of distal radius fractures in the sanitary area of Vigo

Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la península y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9años (IC95%: 65-66,9años). La tasa de incidencia de FEDR fue de 158,5 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50años con FEDR articular compleja.(AU)

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.(AU)

Epidemiological study of distal radius fractures in the sanitary area of Vigo / Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo

Introduction: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. Method: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. Results: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. Conclusion: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.(AU)

Introducción: Las fracturas de la extremidad distal de radio (FEDR) representan una carga cada vez mayor para los recursos sanitarios debido a los cambios demográficos de la población y a las estrategias de gestión, por lo que la comprensión precisa de su epidemiología es esencial. Presentamos un estudio epidemiológico de FEDR y lo comparamos con otras áreas de la península y Europa. Método: Se recogieron todas las FEDR de nuestra área sanitaria registradas en 2017 y 2018 en pacientes mayores de 18años de forma retrospectiva y observacional agrupándolos según la clasificación de AO-OTA. Se analizaron las variables de edad, sexo, época del año, mecanismo de fractura, presencia de lesiones asociadas y tratamiento realizado. Resultados: Registramos 1.121 FEDR en 1.108 pacientes, 903 mujeres (81,5%) y 205 varones (18,5%). En 612 casos se vio afectado el lado izquierdo (54,6%) y en 509 el lado derecho (45,4%). La edad media de la muestra fue de 65,9años (IC95%: 65-66,9años). La tasa de incidencia de FEDR fue de 158,5 fracturas por 100.000 habitantes/año. El 49,2% se clasificaron como tipo A de AO-OTA y se intervinieron quirúrgicamente un 19%. Conclusión: La incidencia de FEDR alcanza un máximo en la sexta década tanto en hombres como en mujeres. Las fracturas de tipo A de la clasificación AO-OTA son las más frecuentes. La mayoría se trataron de forma conservadora. El patrón de paciente tratado quirúrgicamente con más frecuencia es el de una mujer mayor de 50años con FEDR articular compleja.(AU)

Epidemiological study of distal radius fractures in the sanitary area of Vigo. / Estudio epidemiológico de las fracturas de la extremidad distal de radio en el área sanitaria de Vigo.

INTRODUCTION: Distal radius fractures (DRF) are being a bigger burden for health resources as changes continue to happen in our population demography and in management strategies, so a precise epidemiologic comprehension is mandatory. We present a DRF epidemiology study and we compared it with other sanitary areas of the Iberian Peninsula and Europe. METHOD: Every DRF in our sanitary area registered between 2017 and 2018 in patients older than 18 years old were observational and retrospectively recorded and classified using AO-OTA classification. Age, sex, season of the year, mechanism of injury, presence of associated injuries and type of treatment were analysed. RESULTS: 1,121 DRF in 1,108 patients, 903 women (81.5%) and 205 men (18.5%), were registered. Left side was affected in 612 cases (54.6%) and right side in 509 cases (45.4%). The average age of our sample was 65.9 years old (CI95%: 65-67.9 years old). The incidence rate of DRF in our population was 158.5 fractures per 100,000 people-year; 49.2% were classified as type A of AO-OTA classification and 19% were treated surgically. CONCLUSION: Incidence of DRF had a maximum during males and women sixth decade of age. Type A fractures of AO-OTA classification were the most frequent. Most part of the fractures were treated non-surgically. The usual patient treated surgically was a woman, over 50 years old with a distal radius intraarticular complex fracture.

Influence of integrated orthogeriatric care on morbidity and mortality and length of hospital stay for hip fracture. / Influencia de la atención ortogeriátrica integrada en la morbimortalidad y el tiempo de estancia hospitalaria de la fractura de cadera.

BACKGROUND AND OBJECTIVES: Compare the morbidity and mortality, the length of hospital stay and the economic cost of the fragility fracture of the hip, in two nonconsecutive years thanks to the integrated orthogeriatric care. MATERIAL AND METHOD: Retrospective observational cohort study with 633 patients with hip fragility fracture with a mean age of 85.5 years, treated in the same Trauma and Orthopaedic Surgery service in two different years (2012 and 2017). Mean stay, surgical delay, perioperative mortality, one month and one year, and perioperative complications such as acute urine retention, pressure ulcers, and need for transfusion were measured. RESULTS: Mortality during admission decreased from 10% in 2012 to 3.6% in 2017 (P=.004 *), while mortality at thirty days (10.5% vs 7%) (P=.123) and one year (28.9% versus 24.9%) (P=.277). Hospital stay times, surgical delay, and postoperative admission time also decreased. The estimated total annual economic savings thanks to integrated orthogeriatric care amounted to €1,017,084.94. CONCLUSIONS: Integrated orthogeriatric care of the patient with fragility fracture of the hip, results in a more effective and efficient care model. Both the care and the clinical situation of patients are improved in the perioperative period, both hospital stay and mortality during admission are significantly reduced, and all this with significant associated economic savings.