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PubMed2000

Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study.

The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.

Aged↗
PubMed1994

[Study of osteosynthesis strength in femoral neck fractures stabilized with a Zespol hip fixator].

Strength study have been carried out on two different osteotomies of the femoral neck stabilized with Zespol hip fixator, performed on fresh specimens taken out from cadaver. Stability of fixation has been assessed in transverse osteotomy of the neck (Pauwels I type of fracture) and in one parallel to the long axis of the femur (Pauwels III type). The results were compared to similar studies including different fixing methods (DHS, Thornton nail, von Bahr screw, Knowles pin) but identical types of osteotomy, published by other authors. Zespol fixation proved to be equal and frequently superior over other modalities in terms of mechanical stability.

Aged↗
PubMed1990

Comparison of bipolar implants with fixed-neck prostheses in femoral-neck fractures.

A retrospective study of 76 Bateman universal proximal femoral endoprostheses with a mean follow-up period of 32 months was compared to a group of 36 Thompson endoprostheses and 16 Moore endoprostheses, with a mean follow-up period of 35 months and 31 months, respectively. Harris hip scores, when corrected for preoperatively impaired function, yielded a mean score of 85 for the Bateman group, compared to a mean of 77 for both the Thompson and Moore groups. Fifteen patients received the Bateman device for reconstructive purposes and had a mean Harris hip score of 90. Morbidity was comparable between the Bateman and Thompson groups. The deep-infection rate was 3.9%, and the 32-day perioperative mortality was 4.6%, rising to 29% at the time of review. Preselection factors placed younger, more functional patients in the Bateman group (mean age, 65 years; mortality, 11%), compared to the Thompson group (mean age, 72 years; mortality, 39%) and the Moore group (mean age, 73 years; mortality, 41%). Continued evaluation of the Bateman endoprosthesis is required to better define its potential to lessen the long-term problems of pain, loosening, and acetabular wear.

Adult↗
PubMed1991

Osteopenia, hematopoiesis, and bone remodelling in iliac crest and femoral biopsies: a prospective study of 102 cases of femoral neck fractures.

Cancellous microanatomy, bone remodelling, and hematopoietic tissue were studied in iliac crest and femoral neck biopsies taken intraoperatively in 102 consecutive patients with displaced intracapsular fractures. About half of the femoral biopsies had osteopenia, and most showed replacement of hematopoietic tissue by fat cells, with absence of osteoblasts and osteoclasts. In contrast, most of the iliac crest biopsies showed relatively less decrease in cancellous bone, while hematopoietic tissue and bone remodelling cells were present in approximately 75%. These results indicate that the iliac crest biopsy does not necessarily reflect cancellous microanatomy, hematopoietic tissue, and bone remodelling at other skeletal sites in any given patient.

Aged↗
PubMed2004

Osteonecrosis 15 years after femoral neck fracture and long-term low-dose inhaled corticosteroid therapy.

Posttraumatic avascular necrosis of the femoral head typically occurs immediately or within a few years after a femoral neck injury, and non-traumatic avascular necrosis is often related to systemic glucocorticoid therapy. We report an unusual case in which avascular necrosis of the femoral head occurred 15 years after a transcervical femoral fracture in a woman with a 20-year history of daily inhaled glucocorticoid therapy for chronic bronchitis. She had not taken glucocorticoids by any other route and had no other risk factors for osteonecrosis. To our knowledge, this is the first report of osteonecrosis associated with inhaled glucocorticoid therapy in a patient with a local cause of diminished vascular reserve. Inhaled glucocorticoid therapy should be added to the list of risk factors for osteonecrosis.

Administration, Inhalation↗