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[PMID]:29437061
[Au] Autor:Chraim M; Krenn S; Alrabai HM; Trnka HJ; Bock P
[Ad] Endereço:Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.
[Ti] Título:Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot.
[So] Source:Bone Joint J;100-B(2):190-196, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70). RESULTS: The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) - Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS). CONCLUSION: The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: 2018;100-B:190-6.
[Mh] Termos MeSH primário: Artrodese/métodos
Artropatia Neurogênica/cirurgia
Doenças do Pé/cirurgia
Fixação Intramedular de Fraturas
[Mh] Termos MeSH secundário: Adulto
Idoso
Amputação
Desbridamento
Feminino
Seguimentos
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Complicações Pós-Operatórias
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0374.R2


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[PMID]:29382009
[Au] Autor:Tan L; Wang T; Li YH; Yang T; Hao B; Zhu D; Sun DH
[Ad] Endereço:Department of Orthopedic Traumatology.
[Ti] Título:Patellar tendon ossification after retrograde intramedullary nailing for distal femoral shaft fracture: A case report and review of the literature.
[So] Source:Medicine (Baltimore);96(47):e8875, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Retrograde femoral nailing was one of the most important treatment means for distal femoral shaft fracture. However, studies regarding heterotopic ossification of the patellar tendon after retrograde intramedullary nailing for distal femoral shaft fracture are limited. We herein present a rare complication, namely heterotopic ossification of the patellar tendon, after retrograde intramedullary nailing for displaced femoral shaft fracture. PATIENT CONCERNS: We present a case of 25-year-old male with displaced femoral shaft fracture who was treated by retrograde intramedullary nailing. DIAGNOSES: During the period of follow-up, the patient developed symptomatic heterotopic ossification of the patellar tendon with extensively hard ossification area. INTERVENTIONS: Open surgery was recommended, but the patient has refused further treatment. OUTCOMES: The patient resulted in pain and restricted the range of motion of the affected knee. LESSONS: This case stresses the importance of longer-term follow-up and further attention into the possibility of heterotopic ossification of the patellar tendon.
[Mh] Termos MeSH primário: Fraturas do Fêmur/cirurgia
Fixação Intramedular de Fraturas/efeitos adversos
Ossificação Heterotópica/etiologia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adulto
Fixação Intramedular de Fraturas/métodos
Seres Humanos
Masculino
Ossificação Heterotópica/patologia
Ligamento Patelar/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008875


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[PMID]:29381938
[Au] Autor:Ye C; Lai Q; Zhang S; Gao T; Zeng J; Dai M
[Ad] Endereço:Department of Orthopedics, The First Affiliated Hospital of Nanchang University. Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China.
[Ti] Título:Osteopoikilosis found incidentally in a 17-year-old adolescent with femoral shaft fracture: A case report.
[So] Source:Medicine (Baltimore);96(47):e8650, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Osteopoikilosis is a rare and asymptomatic disease of the bone, which is often discovered occasionally on radiography for irrelevant complaints. Characterized by multiple, small, circular, or oval-shaped radiodense lesions, it may be confused with bony metastatic tumors. PATIENT CONCERNS: The present study describes a case of a 17-year-old adolescent who suffered from pain and movement limitation of his left thigh following a fall from standing height. DIAGNOSES: Plain radiographs showed spiral fracture in left femoral shaft; besides, multiple scattered sclerotic lesions of variable size were also observed over the bilateral proximal femurs, left distal femur, proximal tibia, and distal tibia and fibula through X-rays, computed tomography, and magnetic resonance imaging. The patient was finally diagnosed with left femoral shaft fracture and osteopoikilosis. INTERVENTIONS: The patient underwent reduction and internal fixation with intramedullary nail a week after injury. OUTCOMES: The patient was discharged without any complications 12 days after the surgery. At the 3-month follow-up, the patient recovered well and remained symptom-free with no changes to his sclerotic lesions. LESSONS: Although this case is not so complicated, we have to be cautious when differentiating osteopoikilosis and bony metastases in clinical practice in future, which should avoid causing undue distress to both the patients and doctors.
[Mh] Termos MeSH primário: Fraturas do Fêmur/diagnóstico
Fêmur
Fíbula/diagnóstico por imagem
Neoplasias de Tecido Ósseo/diagnóstico
Osteopecilose/diagnóstico
Radiografia/métodos
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Fraturas do Fêmur/cirurgia
Fêmur/diagnóstico por imagem
Fêmur/lesões
Fixação Intramedular de Fraturas/métodos
Seres Humanos
Achados Incidentais
Imagem por Ressonância Magnética/métodos
Masculino
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008650


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[PMID]:29369223
[Au] Autor:Xie L; Zhao Z; Zhang S; Hu Y
[Ad] Endereço:Department of Orthopedic Surgery, Wuhan Orthopedic Hospital, Wuhan Puai Hospital, Huazhong University of Science and Technology, Wuhan.
[Ti] Título:Intramedullary fixation versus plate fixation for displaced mid-shaft clavicle fractures: A systematic review of overlapping meta-analyses.
[So] Source:Medicine (Baltimore);97(4):e9752, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Displaced mid-shaft clavicle fractures (DMCFs) are common injuries. Both intramedullary fixation (IMF) and plate fixation (PF) have been described and routinely used. Multiple trials have been conducted to compare these treatments. Multiple meta-analyses have been published to compare IMF and PF treatment for DMCFs; however, the results remain controversial. The purposes of this study were to perform a systematic review of overlapping meta-analyses comparing IMF and PF treatment for DMCFs, to help decision makers critically evaluate the current meta-analyses, and to propose a guide through the best available evidence. METHOD: We searched the Cochrane library, PubMed, and EMBASE data bases. Two authors independently scanned titles and abstracts to exclude irrelevant articles and identify meta-analyses that met the eligibility criteria. The methodological quality of the meta-analysis was independently assessed by the 2 authors using the Oxford Centre for Evidence-based Medicine Levels of Evidence and the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Heterogeneity information of each variable was extracted from the included studies. An I of <60% is accepted in this systematic review. The Jadad algorithm was then applied to determine which of the meta-analyses provided the best evidence. RESULTS: Eight meta-analysis met the inclusion criteria in this study. AMSTAR scores varied from 7 to 9. Heterogeneity of each outcome was acceptable. Four authors independently selected the same meta-analysis as providing the highest quality of evidence using the Jadad decision algorithm. CONCLUSION: This systematic review of overlapping meta-analyses suggests that compared with PF, major reintervention and refracture after implant removal occurred more frequently after PF of DMCFs. No differences in terms of function and non-union between PF and IMF were observed. Future research should focus on fracture selection for IMF and further improvement of plates and IM devices.
[Mh] Termos MeSH primário: Clavícula/lesões
Fratura-Luxação/cirurgia
Fixação Interna de Fraturas/métodos
Fixação Intramedular de Fraturas/métodos
Fraturas Ósseas/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Placas Ósseas
Clavícula/cirurgia
Feminino
Fixação Interna de Fraturas/instrumentação
Seres Humanos
Masculino
Metanálise como Assunto
Meia-Idade
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009752


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[PMID]:29201305
[Au] Autor:Kim JS; Cho HK; Young KW; Kim JS; Lee KT
[Ad] Endereço:Surgery of Foot and Ankle, Department of Orthopedic Surgery, CM Chungmu General Hospital, Seoul, Korea.
[Ti] Título:Biomechanical Comparison Study of Three Fixation Methods for Proximal Chevron Osteotomy of the First Metatarsal in Hallux Valgus.
[So] Source:Clin Orthop Surg;9(4):514-520, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Fixation of proximal chevron metatarsal osteotomy has been accomplished using K-wires traditionally and with a locking plate recently. However, both methods have many disadvantages. Hence, we developed an intramedullary fixation technique using headless cannulated screws and conducted a biomechanical study to evaluate the superiority of the technique to K-wire and locking plate fixations. Methods: Proximal chevron metatarsal osteotomy was performed on 30 synthetic metatarsal models using three fixation techniques. Specimens in group I were fixated with K-wires (1.6 mm × 2) and in group II with headless cannulated screws (3.0 mm × 2) distally through the intramedullary canal. Specimens in group III were fixated with a locking X-shaped plate (1.3-mm thick) and screws (2.5 mm × 4). Eight metatarsal specimens were selected from each group for walking fatigue test. Bending stiffness and dorsal angulation were measured by 1,000 repetitions of a cantilever bending protocol in a plantar to dorsal direction. The remaining two samples from each group were subjected to 5 mm per minute axial loading to assess the maximal loading tolerance. Results: All samples in group I failed walking fatigue test while group II and group III tolerated the walking fatigue test. Group II showed greater resistance to bending force and smaller dorsal angulation than group III ( = 0.001). On the axial loading test, group I and group II demonstrated superior maximum tolerance to group III (54.8 N vs. 47.2 N vs. 28.3 N). Conclusions: Authors have demonstrated proximal chevron metatarsal osteotomy with intramedullary screw fixation provides superior biomechanical stability to locking plate and K-wire fixations. The new technique using intramedullary screw fixation can offer robust fixation and may lead to better outcomes in surgical treatment of hallux valgus.
[Mh] Termos MeSH primário: Fixação Intramedular de Fraturas/métodos
Hallux Valgus/cirurgia
Fixadores Internos
Ossos do Metatarso/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Placas Ósseas
Parafusos Ósseos
Fios Ortopédicos
Fixação Intramedular de Fraturas/instrumentação
Seres Humanos
Teste de Materiais
Modelos Anatômicos
Falha de Prótese
Estresse Mecânico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.514


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[PMID]:28467335
[Au] Autor:Pogliacomi F; Mijno E; Pedrazzini A; Tocco S; Tonani M; Ceccarelli F; Vaienti E
[Ad] Endereço:PARMA UNIVERSITY DEPARTMENT OF MEDICINE AND SURGERY ORTHOPAEDIC AND TRAUMATOLOGY SECTION. fpogliacomi@yahoo.com.
[Ti] Título:Fifth metacarpal neck fractures: fixation with antegrade locked flexible intramedullary nailing.
[So] Source:Acta Biomed;88(1):57-64, 2017 Apr 28.
[Is] ISSN:0392-4203
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing. MATERIALS AND METHODS: All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE). Active and passive range of motion (ROM) of metacarpo-phalangeal (MP), proximal and distal interphalangeal (PIP and DIP) joints and Total Active Motion (TAM), and grip strength were also analyzed. Apex dorsal angulation and axial shortening were radiologically measured preoperatively and at final follow-up. RESULTS: Clinical and radiological results which were observed were satisfactory. No TAM and grip strength differences were recorded between the operated and healthy contralateral hand. CONCLUSIONS: According to the positive outcomes and the low rate of complications of this study, antegrade locked flexible intramedullary nailing can be considered a valid treatment option in boxer's fractures.
[Mh] Termos MeSH primário: Fixação Intramedular de Fraturas
Fraturas Ósseas/cirurgia
Ossos Metacarpais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Avaliação da Deficiência
Feminino
Seguimentos
Consolidação da Fratura
Força da Mão
Seres Humanos
Masculino
Ossos Metacarpais/lesões
Meia-Idade
Amplitude de Movimento Articular
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180125
[Lr] Data última revisão:
180125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.23750/abm.v88i1.6195


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[PMID]:29182112
[Au] Autor:Rapp M; Grauel F; Wessel LM; Illing P; Kaiser MM
[Ti] Título:Treatment outcome in 60 children with pathological fractures of the humerus caused by juvenile or aneurysmal bone cysts.
[So] Source:Acta Orthop Belg;82(4):723-729, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:The treatment of pathological fractures of the humerus caused by juvenile or aneurysmal bone cysts (JBC/ABC) should be a single approach with a high success rate and low complication rate. This study evaluates how day by day treatment concepts fulfil these aims. Children below 15 years of age with a pathological fracture of the humerus caused by a JBC or ABC between 01.01.2001 and 31.12.2010, were investigated by chart review in four major paediatric trauma centres. Age, gender, fracture localisation, X-ray findings, treatment and outcome - assessed by the Capanna classification (I to IV), were analysed. 60 children [41male, 19 female; mean age: 9 years (4-14 years)] with 43 JBC and 12 ABC were included as well as five cysts, who could not be classified definitively. First treatment was non-operatively in 33 children. Of these 27 cysts did not improve; likewise the supportive installation of cortisone in six patients did not change the outcome. The first treatment consisted of elastic stable intramedullary in 13 children; up to three nail exchanges included. But only six of these reached (nearly) complete resolution (I/II). Overall the combined mechanical and biological treatment with curettage, elastic stable intramedullary nailing, (artificial) bone substitute and in some cases growth factors was performed as the 1st-line treatment in nine patients and further in 2nd or 3rd-line treatments in 13 humeral cysts. More than half of these reached a complete or nearly complete resolution of the cyst (12x I, 5x II, 1x III, 4x IV). Major complications in all operated patients were six nails not removable and two children with upper extremities length differences. Healing rates are low for non-operative treatment, elastic stable intramedullary nailing alone and by using cortisone for cysts resolution in pathological fractures of the humerus. Data support a combined mechanical and biological treatment with curettage, elastic stable intramedullary nailing, (artificial) bone substitute and the use of growth factors.
[Mh] Termos MeSH primário: Anti-Inflamatórios/uso terapêutico
Cistos Ósseos Aneurismáticos/terapia
Substitutos Ósseos/uso terapêutico
Cortisona/uso terapêutico
Fixação Intramedular de Fraturas/métodos
Fraturas Espontâneas/terapia
Fraturas do Úmero/terapia
[Mh] Termos MeSH secundário: Adolescente
Cistos Ósseos/complicações
Cistos Ósseos/diagnóstico por imagem
Cistos Ósseos/terapia
Cistos Ósseos Aneurismáticos/complicações
Cistos Ósseos Aneurismáticos/diagnóstico por imagem
Pinos Ortopédicos
Criança
Pré-Escolar
Tratamento Conservador
Feminino
Consolidação da Fratura
Fraturas Espontâneas/diagnóstico por imagem
Fraturas Espontâneas/etiologia
Seres Humanos
Fraturas do Úmero/diagnóstico por imagem
Fraturas do Úmero/etiologia
Injeções Intralesionais
Masculino
Radiografia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Bone Substitutes); V27W9254FZ (Cortisone)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29182105
[Au] Autor:Zhang YT; Jin D; Niu J; Li ZJ; Fu S; Zou ZL
[Ti] Título:A meta-analysis of external fixation and flexible intramedullary nails for femoral fractures in children.
[So] Source:Acta Orthop Belg;82(4):673-680, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:Background : The purpose of this meta-analysis was to compare the outcomes of external fixation and flexible intramedullary nails for femoral fractures in children between 5 and 15 years of age based on the current evidence. Materials and methods: We searched relevent studies in the following database: Cochrane library, PubMed and EMABASE up to May 2014. All randomized controlled trials, Clinical controlled trials and retrospective controlled studies comparing external fixation and flexible intramedullary nails in femoral fractures of children were included. Data was extracted independently for meta-analysis. Results: Seven trials altogether involving 338 cases of femoral fractures of children treated by external fixation (128 cases) and flexible intramedullary nails (210 cases) were included in the meta-analysis. Results showed that flexible intramedullary nails was superior to external fixation in less time to union , lower postoperative infection rate and refracture rate . It may not increase delayed union, Limb-length discrepancy , pain and bursitis . Both fixations obtained a similar patient satisfaction. conclusion: Flexible intramedullary nail had greater advantages for the treatment of femoral fractures in children aged 5-15 years, compared to external fixation based on current meta-analysis. This conclusion will ultimately require rigorous and adequately powered randomized controlled trials to be proved.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Fraturas do Fêmur/cirurgia
Fixação Intramedular de Fraturas/métodos
Consolidação da Fratura
Dor Pós-Operatória/epidemiologia
Infecção da Ferida Cirúrgica/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Bursite/epidemiologia
Criança
Pré-Escolar
Fixação de Fratura/métodos
Seres Humanos
Desigualdade de Membros Inferiores/epidemiologia
Satisfação do Paciente
Complicações Pós-Operatórias/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29257017
[Au] Autor:Bohl DD; Shen MR; Hannon CP; Fillingham YA; Darrith B; Della Valle CJ
[Ad] Endereço:Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
[Ti] Título:Serum Albumin Predicts Survival and Postoperative Course Following Surgery for Geriatric Hip Fracture.
[So] Source:J Bone Joint Surg Am;99(24):2110-2118, 2017 Dec 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Serum albumin level is the most well-established serum marker of malnutrition, with a serum albumin concentration <3.5 g/dL considered to be suggestive of malnutrition. The purpose of this study was to test if serum albumin level is associated with death, specific postoperative complications (e.g., pneumonia), length of hospital stay, and readmission following a surgical procedure for geriatric hip fracture. METHODS: A retrospective cohort study of geriatric patients (≥65 years of age) undergoing a hip fracture surgical procedure as part of the American College of Surgeons National Surgical Quality Improvement Program was conducted. Outcomes were compared between patients with and without hypoalbuminemia. All comparisons were adjusted for baseline and procedural differences between populations, and patients with missing serum albumin concentration were included in analyses using a missing data indicator. RESULTS: There were 29,377 geriatric patients undergoing a hip fracture surgical procedure who met inclusion criteria; of these patients, 17,651 (60.1%) had serum albumin available for analysis. The prevalence of hypoalbuminemia was 45.9%. Following adjustment for baseline and procedural characteristics, the risk of death was inversely associated with serum albumin concentration as a continuous variable (adjusted relative risk, 0.59 [95% confidence interval (CI), 0.53 to 0.65]; p < 0.001). In comparison with patients with normal albumin concentration, patients with hypoalbuminemia had higher rates of death (9.94% compared with 5.53% [adjusted relative risk, 1.52 (95% CI, 1.37 to 1.70); p < 0.001]), sepsis (1.19% compared with 0.53% [adjusted relative risk, 1.92 (95% CI, 1.36 to 2.72); p < 0.001]), and unplanned intubation (2.64% compared with 1.47% [adjusted relative risk, 1.51 (95% CI, 1.21 to 1.88); p < 0.001]). The mean length of stay (and standard deviation) was longer among patients with hypoalbuminemia at 5.67 ± 4.68 days compared with those without hypoalbuminemia at 4.99 ± 3.95 days; the adjusted difference was 0.50 day (95% CI, 0.38 to 0.63 day; p < 0.001). However, the rate of readmission did not differ (p = 0.054) between patients with hypoalbuminemia (10.91%) and those without hypoalbuminemia (9.03%); the adjusted relative risk was 1.10 (95% CI, 1.00 to 1.21). CONCLUSIONS: Hypoalbuminemia is a powerful independent risk factor for mortality following a surgical procedure for geriatric hip fracture. These data suggest that further investigation into postoperative nutritional supplementation is warranted to decrease the risk of complications. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Fixação Intramedular de Fraturas/efeitos adversos
Fraturas do Quadril/mortalidade
Fraturas do Quadril/cirurgia
Mortalidade Hospitalar/tendências
Albumina Sérica/análise
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/métodos
Biomarcadores/sangue
Estudos de Coortes
Feminino
Fixação Intramedular de Fraturas/métodos
Avaliação Geriátrica/métodos
Fraturas do Quadril/diagnóstico por imagem
Seres Humanos
Escala de Gravidade do Ferimento
Estimativa de Kaplan-Meier
Tempo de Internação
Masculino
Análise Multivariada
Complicações Pós-Operatórias/mortalidade
Complicações Pós-Operatórias/fisiopatologia
Prognóstico
Estudos Retrospectivos
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Serum Albumin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01620


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Fotocópia
[PMID]:29193912
[Au] Autor:Rivera Rosado E; Hernandez Ortiz E; Lopez Aponte C; Marrero Ortiz PV
[Ti] Título:Bilateral Tibia Fibrous Dysplasia in a Pediatric Patient Treated with Intramedullary Nailing: A Case Report.
[So] Source:Bol Asoc Med P R;108(1):21-3, 2016.
[Is] ISSN:0004-4849
[Cp] País de publicação:Puerto Rico
[La] Idioma:eng
[Ab] Resumo:Fibrous dysplasia is benign developmental disorders of bone where normal lamellar cancellous bone is replaced with immature fibro-osseus tissue resulting in poorly formed trabeculae of immature woven bone. It may affect one (monostotic) or multiple bones (polyostotic). Polyostotic disease is less common, 20-25% of patients, mostly in children below 10 years old and tends to enlarge beyond bone maturation ration which can cause pain, progressive damage and higher tendency of pathological fractures.(1) We report a case of polyostotic fibrous dysplasia present on bilateral tibia diaphysis. Patient presented with bilateral leg pain on examination and imaging showed bilateral tibia lytic lesion. Management consisted of reaming and intramedullary nailing on bilateral tibia after which patient presented without pain and radiographs showing no evidence of lesion. Tibia x-rays demonstrated exuberant cortical intramedullary bone formation with disappearance of the scalloped osteolytic lesions on the inner wall of tibial cortex. Clinically the patient's symptoms disappeared giving the opportunity to return to contact sports without limitation.
[Mh] Termos MeSH primário: Displasia Fibrosa Poliostótica/cirurgia
Fixação Intramedular de Fraturas/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Pinos Ortopédicos
Seres Humanos
Masculino
Dor/etiologia
Tíbia/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE



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