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A pensioner with ‘waterworks’ problems
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
The consequences range from a loss of mobility in fitter patients, to death from complications in the very frail. Despite significant improvements in the detection and prevention of osteoporosis, surgery and rehabilitation, mortality following hip fracture is still approximately 30% in the year following injury.
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Published in Henry J. Woodford, Essential Geriatrics, 2022
Pressure ulcers (PUs) are also sometimes called ‘pressure sores', ‘bedsores' or ‘decubitus ulcers'. They develop in areas where pressure on the skin overlying a bony prominence restricts capillary blood flow, resulting in tissue hypoxia then necrosis and breakdown. Classic sites are over the sacrum, ischial tuberosities and heels (seeFigure 22.2). This process is worsened by a reduction in the natural padding provided by subcutaneous fat associated with poor nutrition and other factors such as moisture levels (including incontinence), shear and friction forces (e.g. sliding down the bed or when being transferred) and superimposed infections. Older people are at an increased risk, especially following hip fracture or spinal injury. The prevalence of PUs in hospitalised people is around 3–14%.72 Estimates of the prevalence of PUs among people residing in care homes are in the range of 3–32%.73
Orthopaedics
Published in Kelvin Yan, Surgical and Anaesthetic Instruments for OSCEs, 2021
The primary indication for a hip replacement is arthritis-related pain. Functional limitation of arthritis is another indication, usually associated with pain. The main cause is osteoarthritis. Other causes include rheumatoid arthritis and any inflammatory joint conditions. Stiffness from conditions such as ankylosing spondylitis is so debilitating that it would warrant a hip replacement even when not associated with pain. Another common indication is hip fracture.
Cut-off values and sub-items of the Berg Balance Scale for walking-aid use in hospitalized older adults with a hip fracture: a retrospective analysis
Published in Physiotherapy Theory and Practice, 2023
Sota Kobayashi, Kazuhiro Miyata, Shuntaro Tamura, Ren Takeda, Hiroki Iwamoto
In this retrospective cross-sectional study, the medical records of the older adults who were hospitalized for a hip fracture between April 2018 and June 2020 at three hospitals in Japan were collected. The inclusion criteria were: 1) the presence of a unilateral hip fracture due to a fall; 2) age ≥ 65 years; 3) hospitalized for rehabilitation within 3 months after the hip fracture; and 4) being able to walk > 15 m independently (Functional Ambulation Category ≥ 4). The exclusion criteria were: 1) the presence of a severe neurological complication due to stroke or Parkinson’s disease; 2) missing BBS data at discharge in the individual’s medical records; 3) refusal to participate in the study during the opt-out period; and 4) the individual’s fall occurred after the April 16, 2020 Covid-19 emergency declaration in Japan.
Discovery of potential biomarkers for osteoporosis diagnosis by individual omics and multi-omics technologies
Published in Expert Review of Molecular Diagnostics, 2023
OP-related fractures are usually vertebral, hip, and wrist fractures [31]. Vertebral fractures are the most common type of osteoporotic fractures, and their incidence is estimated to be three times that of hip fractures [32]. Owing to a possible lack of symptoms, more than two-thirds of vertebral fractures have not been diagnosed, and only one-third have received medical care [32,33]. Hip fracture is the type of fracture with the highest mortality rate, and the risk of death in the long-term can be doubled; 12%-17% of patients die within the first year of hip fracture [34]. Patients with hip fractures may develop cardiovascular, pulmonary, thrombosis, infection, bleeding, and other complications, leading to death [35]. Among them, venous thromboembolism is the second most common complication of hip fracture surgery, whereas pulmonary embolism is the fourth most common cause of death after hip fracture surgery, with an incidence of 0.66%–7.5% [36]. It is worth noting that a previous hip fracture is a risk factor for another hip fracture; therefore, early assessment of an individual’s risk of OP is important to prevent a first fracture [34].
The effect of gait training with low-intensity neuromuscular electrical stimulation of hip abductor muscles in two patients following surgery for hip fracture: Two case reports
Published in Physiotherapy Theory and Practice, 2022
Kazuya Takeda, Soichiro Koyama, Koji Shomoto, Kosuke Ushiroyama, Yuki Naoi, Tomoko Nagai, Hiroaki Sakurai, Yoshikiyo Kanada, Shigeo Tanabe
Hip fracture is a common trauma in elderly adults (Bitsch, Foss, Kristensen, and Kehlet, 2004; Carroll et al., 2011). Assuming that the incidence will increase by 1% per year as the population ages, it is expected that the total global number of hip fractures will reach 8.2 million in 2050 (Sambrook and Cooper, 2006). Hip fracture itself and postoperative sequelae both cause various impairments and disabilities including pain, decreased range of motion, and impairment of gait and balance (Alley et al., 2011; Foss, Kristensen, Palm, and Kehlet, 2009; Leegwater et al., 2016; Thingstad et al., 2015). It has been reported that approximately 50% of patients with femoral head replacement surgery following hip fracture cannot regain the ability to live independently (Morrison, Chassin, and Siu, 1998). Moreover, the hip fracture itself and the postoperative sequelae are associated with a high risk of mortality (Nikkel et al., 2015) and decreased quality of life (Alexiou, Roushias, Varitimidis, and Malizos, 2018).