Proximal femur fracture is not only a medical problem but also a social handicap. Our objective is to see, by means of a prospective observational study, how the function varies after hip fracture and which are the most influencing factors in order to get maximum benefits of resources for this patology.
86 female and 21 male. Mean age 74 years (65–93).44 suffering subcapital fracture and 63 pertrochanteric fracture. 76 patients underwent gamma nail or canulated screws and 31 hemi or total hip replacement. Mean surgery delay 3 days (1–14) At the moment of hospital registration we also determined marital status, familiar support, living at home or institution, morbidity pre- fracture (according to Charlson index), level of dependence (Barthel index), mental status (Folstein Mini Mental State Examination)quality of life perceived (short form 36 (SF-36)) and depression symptoms (Geriatric Depression Scale 15 (GDS 15)). At three months post discharge we determined again all the test mentioned before and also recorded the functional level (Harris test), which haven’t been passed preoperatively because it includes a part of physical evaluation, not possible to do in a fractured leg.
There were no significant differences between functional outcome al three months and delay of the surgery (p 0.76) or the type of surgery (artroplasty vs osteosintesis) (p0.308). There was a negative correlation (rho-spearman −0.656)between depression and functional outcome, the more depressed a patient is the worse functional outcome he has (p 0.002) There was a positive correlation (rho-spearman 0.605) between function (Harris test) and dependency (Barthel index).Patients less independent pre fracture are the ones with low function at three months. (p 0.000)
The objective of this study is to analyze changes in the force needed to raise the arm caused by using a single or a double-row configuration of cuff repair. Cadaveric study performed using 5 fresh-frozen shoulders. Supraspinatus tear created in all specimens beginning 0.5 cm from biceps tendon. Repair of tear with single and double-row configuration of anchors placed 1cm apart each one. Sutures fixed to digital dynamometer. Continuous traction applied and registered to elevate humerus to 30° and 45°. Experiment repeated 3 times for each configuration and angle of elevation on each specimen. Paired Student t test was used to compare difference between single and double-row configuration at 30° and 45° of anterior elevation. Significant differences between force needed to raise the arm to 30° with single-row (4,76 kg) configuration and double-row (6,94) (p<
0,001). Significant differences between force needed to raise the arm to 45° with single-row configuration (10,32 kg) and double-row (15,93) (p<
0,008). Significant differences when comparing mean increase of force needed to raise the arm from 30° to 45° between single and double-row configuration (p<
0,012). The force needed to raise the arm to 30° and 45° is significantly higher for double than for single-row configuration. Quality of tendon margin should be taken into account when choosing between double and single-row configuration. If repair is done to a frayed and degenerated tendon, surgeon has to imbalance benefits of double-row repair with the fact that tendon suture will have to resist an increased force in active movement.