Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:P50502 (Hip)
 7,003 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four hundred consecutive hip fractures were studied prospectively. Two hundred forty-seven patients were classified as unhealthy (poor cardiac status, pneumonia, cancer history, bowel obstruction history, malnutrition, dehydration, stroke history, renal failure history, cirrhosis). Twenty-two percent of this unhealthy group died, while only 6% of the remaining healthy group died. Death rates varied with admission activity level and mental status but not when patient health status was factored out. After factoring out health status, age was associated with higher death rates only in patients older than age 85. Confusion, a change of mental status in the hospital, occurred in 25% of patients. Confusion was associated with a medical complication in 94% of cases, was the presenting symptom of a medical complication in 79% of cases, and was associated with a 39% death rate. Major medical complications occurred in 9% of the healthy group (29% of them died) and 21% of the unhealthy group (64% of them died). Major medical complications in unhealthy, shut-in patients were associated with an 80% death rate. Vigorous urinary tract monitoring and early treatment of bacteriuria decreased death rate. Postfracture malnutrition was associated with higher complication rates. Hip surgery performed within 72 hours on patients with acute medical illnesses in addition to their fracture was associated with a higher death rate. Whether a patient walked postfracture seemed not to be correlated with the death rate. Patients who were not walking prefracture but treated by internal fixation had a 34% failure rate.
 ...
PMID:Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. 161 47

Fractures of the femoral head infrequently accompany hip dislocations, but create complex therapeutic dilemmas for the orthopaedist when they do occur. The difficulties are compounded by existing incomplete classification schemes, which do not satisfactorily predict the final clinical results of a given injury or treatment. This chapter encompasses an extensive literature review of 238 published cases and analyzes the areas of confusion concerning this group of injuries. Our experience with 27 cases of femoral head fracture is presented. These examples emphasize the need for prompt, concentric reduction of the hip joint followed by individualized treatment of each type of femoral head fracture. An improved classification system to eliminate the ambiguities of previous systems and to provide the clinician with treatment guidelines for each type of femoral head fracture is proposed. These guidelines should improve the final results in these difficult and rare injuries.
Hip 1987
PMID:Fractures of the femoral head. 354 15

Hip fractures in elderly and senile patients are associated with a high incidence of morbidity and mortality. For this reason, restoration of function rather than restoration of the hip must be the first concern. In senile patients with intertrochanteric fractures, condylocephalic fixations is preferred because of the decreased infection rate. In patients with severe osteoporosis, bed rest with traction as needed for comfort may be preferable. Fractures of the femoral neck in this group are best treated with percutaneous pin fixation. In the elderly ambulatory patient with no more than minimal confusion, compression screw fixation with severe osteoporosis in these patients should have adjunctive use of methylmethacrylate. In this group, fractures of the femoral neck in our experience are better treated with a cemented endoprosthesis or total hip arthroplasty.
 ...
PMID:Treatment of hip fractures in elderly and senile patients. 720 84

Hip fracture surgery is common and the population at risk is generally elderly. There is no consensus of opinion regarding the safest form of anaesthesia for these patients. We performed a meta-analysis of 15 randomized trials that compare morbidity and mortality associated with general or regional anaesthesia for hip fracture patients. There was a reduced 1-month mortality and incidence of deep vein thrombosis in the regional anaesthesia group. Operations performed under general anaesthesia had a reduction in operation time. No other outcome measures reached a statistically significant difference. There was a tendency towards a lower incidence of myocardial infarction, confusion and postoperative hypoxia in the regional anaesthetic group, and cerebrovascular accident and intra-operative hypotension in the general anaesthetic group. We conclude that there are marginal advantages for regional anaesthesia compared to general anaesthesia for hip fracture patients in terms of early mortality and risk of deep vein thrombosis.
 ...
PMID:General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. 1110

Hip fractures are one of the leading causes for admission of elderly subjects to healthcare facilities. Because of population aging, the incidence of hip fractures has increased considerably over the last years and will continue to increase in industrialized countries. Hip fracture in an elderly subject may be life threatening and has a significant functional and social impact not only because of the fracture itself, but also because of the risk of complications related to the patient's health status and the long hospital stay. The purpose of this work was to identify in the published literature professional practices, excepting the surgical procedure, associated with better early and long-term outcome in elderly patients with hip fracture. Questions raised concerning the patient's hospital stay include factors related to the preoperative phase (time to surgery, usefulness of traction), the operation itself (antibiotic prophylaxis, anesthesia technique), and the postoperative phase (prevention of venous thrombosis, malnutrition, episodes of confusion, duration of indwelling bladder catheter, correction of anemia, geriatric care during the stay in the orthopedic ward, early and intense rehabilitation, prevention of recurrence). Among these factors, several appear to be associated with better outcome, including long-term outcome--surgery as early as possible in light of the patient's general status, antibiotic prophylaxis in accordance with standard recommendations (SFAR), prevention of venous thrombosis with low-molecular-weight heparin initiated at admission and associated with elastic contention. Oral nutritional support is probably beneficial and should be proposed for all patients. Particular attention must be given to prevention of confusion in order to reduce the rate of institutionalization. The rythm of rehabilitation exercises should be at least five sessions per week. Finally, there are several methods, which are effective in preventing recurrence, taking into account osteoporosis, risk of falls. Preventive measures should be instituted for all patients undergoing surgery for hip fracture.
 ...
PMID:[Factors affecting quality of care for elderly subjects undergoing surgery for hip fracture: review of the literature]. 1567 17

This study discusses the definition of operative, anatomic and radiographic acetabular anteversion and their effect on a long posterior wall cup. In this cadaveric study, anteversion was modelled radiographically with a Charnley double wire marker Long Posterior Wall (LPW) cup and the position of the long posterior wall was studied with relation to different anteversion angles, and also correlated with computer generated line diagrams of the acetabular cup. The position of a long posterior wall varies when different types of anteversion are applied. By increasing the operative anteversion the long posterior wall comes to lie inferiorly and the advantage of the long posterior wall is lost. In light of prior confusion with definitions and in an attempt to make the terms more relevant to the surgical technique we propose the simplified alternate terms of 'flexion-anteversion' previously called 'operative anteversion', 'internal rotation-anteversion' previously called 'anatomic anteversion' and 'combined anteversion' previously called 'radiographic anteversion'. If the surgeon elects to use LPW it is important to understand the effect of each type of anteversion on eventual position of the raised wall.
Hip Int
PMID:Acetabular version and long posterior wall cup in total hip replacement. 1864 68

The increasing life expectancies among octogerians ang nanogerians cause increased need for total hip replacement in this age group. The aim of our study was to analyze final results after total hip arthroplasty in patients 75 years of age and older. Clinical and radiological retrospective study was performed on a group of 59 patients (72 hips) in the mean age of 78 years. Minimal follow-up was 3 years. According to Harris Hip Score hip function improved on an average of 47 points and at final follow-up was 86 points. Patients with medical diseases had poorer hip function improvement. Early dislocation was found in 3 patients with was treated conservatively with good result. Almost 1/4 of patients suffered medical postoperative complications: pneumonia (n = 1), urinary tract infection (n = 4), pulmonary embolism (n = 1), acute myocardial infarction (n = 1), postoperative confusion (n = 5) and mild intestinal occlusion (n = 1). Additionally, one patient died for pulmonary embolism. There were no radiological signs of aseptic loosening or need for revision operation. Three fourth of our patients had satisfactory results after total hip replacement, despite relatively high medical (24%) and local complication rate. Aseptic loosening is rear in this age group.
 ...
PMID:[Elective total hip arthroplasty for patients 75 years of age and older]. 1884 21

Bone cement implantation syndrome (BCIS) is poorly understood. It is an important cause of intraoperative mortality and morbidity in patients undergoing cemented hip arthroplasty and may also be seen in the postoperative period in a milder form causing hypoxia and confusion. Hip arthroplasty is becoming more common in an ageing population. The older patient may have co-existing pathologies which can increase the likelihood of developing BCIS. This article reviews the definition, incidence, clinical features, risk factors, aetiology, pathophysiology, risk reduction, and management of BCIS. It is possible to identify high risk groups of patients in which avoidable morbidity and mortality may be minimized by surgical selection for uncemented arthroplasty. Invasive anaesthetic monitoring should be considered during cemented arthroplasty in high risk patients.
 ...
PMID:Bone cement implantation syndrome. 1945 Nov 60

Valgus slips of the epiphysis are rare, making radiological diagnosis difficult. A high degree of clinical suspicion is required to diagnose the condition. The patient was a 13-year, 7-month-old girl who had been suffering from pain in the left thigh for ten days. She had a limp and a positive Trendelenburg sign. Menstrual function had started when she was 12 years and 10 months old. Pain occurred with getting up from a chair. Hip radiographs revealed symmetrical, bilateral caput valgum, which was a potential cause of confusion given the valgus displacement of the proximal femoral epiphysis. Axial view showed an almost imperceptible posterior slip. The patient was diagnosed as having a valgus slipped capital femoral epiphysis (SCFE). Surgical treatment was performed using in-situ fixation with a cannulated, fully threaded percutaneous screw placed through the external cortex of the femoral neck. Non-weight-bearing for six weeks was prescribed. Although a medial approach is usually used for screw insertion using a more medial entry-point, preventing neurovascular risks, in-situ fixation (through a lateral approach) was performed more safely and distally. This was done through the outer cortex of the femoral neck (and centered in the axial view), to achieve fixation of the femoral head in the center of the femoral neck and head.
 ...
PMID:Valgus slipped capital femoral epiphysis. 2104 97

The purpose of this descriptive cohort study was to identify perioperative risk factors associated with postoperative outcome up to 4 months after surgery in elderly patients with hip fracture. Data were collected prospectively through the Swedish National Hip Fracture, the local Acute and Emergency, and Anesthesia registers, and retrospectively from medical and nursing records. The 428 patients (aged > or = 65 years) with hip fracture were consecutively included. Multiple logistic regression analyses were used to identify factors predicting each of 4 outcomes. Perioperative risk factors predicting death within 4 months after surgery were fasting time of 12 or more hours and blood transfusion of 1 U or more. Risk factors predicting postoperative confusion were postoperative oxygen saturation less than 90% and fasting time 12 hours or longer. Risk factors predicting in-hospital complications were transfusion of 1 or more units of blood, preoperative oxygen saturation less than 90%, and fasting time 12 hours or more. Risk factor predicting length of stay longer than 10 days was blood transfusion of 1 U or more. To minimize morbidity and mortality, providers should increase efforts to optimize the patients' oxygen saturation and hemoglobin level and reduce fasting time and waiting time for surgery.
 ...
PMID:The influence of perioperative care and treatment on the 4-month outcome in elderly patients with hip fracture. 2147 27


1 2 Next >>