Introduction: Compromised by pre-existing medical co-morbidities, weakened by the second hit of surgery, elderly patients with hip fractures are amongst the most challenging cases to manage appropriately in the acute hospital setting. Aim: To document the frequency and outcome of post operative medical complications in elderly patients following surgery for hip and proximal femoral fractures. Methods: Retrospective analysis of acute admissions to a University teaching hospital with hip and pertrochanteric fractures over an 18 month period. Medical records and radiographs were reviewed for details relating to location of fracture, in-patient morbidity, mortality and length of stay. In-patient fracture referrals and patients under 65 years of age were excluded. Results: From a total of 438 fracture fixation procedures or prosthetic replacements, 368 patients were eligible for analysis. The mean age of patients was 83.6 years. The mean length of stay was 14.2 days. 142 patients experienced significant postoperative morbidity consisting of 24 myocardial infarctions, 46 respiratory tract infections, 33 urinary tract infections, 3
Purpose: To analyze the long-term functional outcome of vertical shear fractures to other forms of severe pelvic injuries: APC-III, LC-III, and complex acetabular fractures. Patients and Methods: Out of 561 patients with pelvic ring injuries we identified 31 vertical shear fractures in 29 consecutive patients (4 female). A retrospective chart analysis was performed and the following data was recorded: age, sex, mechanism of injury, associated injuries, Injury Severity Score (ISS), resuscitation requirements, method of stabilization, intensive care unit (ICU) or high dependency unit (HDU) stay, duration of hospital stay, urogenital injuries, neurological injury, systemic complications, time to union and mortality. The same parameters were assessed and analyzed in a control group comprising of 98 patients: 34 patients with APC–III, 32 patients with LC-III and 32 patients with complex (at least bicolumnar) ace-tabular fractures. All patients in the control group were matched for age and sex with the vertical shear fracture group. The mean follow up was 62 months. At final follow up, functional outcome was assessed in all patients using the following generic outcome measurement tools: Euro-Qol 5D (EQ), SF36 v2 (Short form), VAS (Visual analogue score), SMFA (Short musculoskeletal functional assessment) and Majeed score. In addition Merle d’ Aubignæ and Postel scores (Matta modification – 1986) and radiologic degenerative hip scores (Matta 994) were used to assess patients with acetabular fractures. Results: The mean age of all the patients in the study was 43.5 years (16–71) and the median injury severity score was 22 (12–32). Motor vehicle accidents accounted for 79% of the injuries. All patients had their pelvic ring stabilized at least temporarily within 24 hours and all acetabular fractures were reduced and stabilized by 7 days. The mean hospital stay was 26 (9–176) days. Functional outcome was assessed in all patients of the control group and in 28/29 patients of the vertical shear fracture group (1 patient died as a result of a