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Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_9 | Pages 8 - 8
1 May 2018
Zourob E Latimer L Mohamed A Anto J Rajeev A
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Introduction. Patients with pre-existing dementia are more susceptible to hip fracture due to various risk factors such as age, decreased activity leading to sarcopenia and osteoporosis, Vitamin D deficiency and presence of Apolipoprotein gene. The mortality associated with dementia and fracture neck of femurs was thought to be 2.3 times more than that of patients with intact cognitive function. The aim of this study is to assess the mortality of patients at 28 days, 4 months and one year after undergoing surgery for fracture neck of femurs. Methods. A retrospective study of 184 patients admitted with fracture neck of femur and had dementia for a period from April 2014 to August 2016 were carried out. The patient demographics, AMT score, pre-operative co-morbidities, perioperative mortality and one year mortality were analysed. Results. A total no. of 1007 patients was admitted with fracture neck of femurs during the study period. 184 patients were found to have pre fracture dementia. The mean age was87.088 years (Range 64–101). There was 42 males and 142 females. The average ASA grade was 2–3. 99 patients (53.8%) had Alzheimer's disease, 50 patients (27%) had vascular dementia and 35 patients (19.2%) had other types of dementia.94 patients (51%) had more than one co-morbidity. The average AMT score was 0.66(normal range 0–10). The total number of patients died was 114(62%). The overall mortality at 28 days was 24 %(44 patients=0.0001), 4 months was 46 %(84 patients) and one year was 62 %(114 patients, p=0.0001). In 90(49%) patients who had only dementia and no other co-morbidities(ASA grade 1–2) the mortality at 28 days was 20% (p=0.0051), 4 months was 40% and at one year 61%(p=0.0001). Conclusion. In our study we found that the overall mortality in patients with dementia and fracture neck of femurs is 62% and the perioperative mortality rate was 24%. The peri-operative mortality rate was 20% in patients with pure dementia. The mortally rate in dementia with fracture neck of femurs patients was far more than what is noted in the literature


The Bone & Joint Journal
Vol. 101-B, Issue 11 | Pages 1459 - 1463
1 Nov 2019
Enishi T Yagi H Higuchi T Takeuchi M Sato R Yoshioka S Nakamura M Nakano S

Aims

Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for acetabular dysplasia. The purpose of this study was to investigate changes in muscle strength, gait speed, and clinical outcome in the operated hip after RAO over a one-year period using a standard protocol for rehabilitation.

Patients and Methods

A total of 57 patients underwent RAO for acetabular dysplasia. Changes in muscle strength of the operated hip, 10 m gait speed, Japanese Orthopaedic Association (JOA) hip score, and factors correlated with hip muscle strength after RAO were retrospectively analyzed.