PURPOSE: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a serious and life-threatening complication in elderly (older than 65 years) patients undergoing hip fracture surgery (HFS). However, few have reported on the influences of VTE on postoperative rehabilitation in these patients. This study was performed to determine whether VTE affects clinical outcomes in patients who underwent HFS. MATERIALS AND METHODS: We retrospectively evaluated 330 HFSs in 325 consecutive patients, which were performed from January 2009 to June 2010. From chart review, we identified 15 patients with symptomatic VTE. We compared Geriatric depression scale, Modified Barthel index and Berg balance scale scores as well as 10 meter gait speed at discharge and hospital stay between a symptomatic VTE group and a non-VTE group. RESULTS: No significant difference in clinical outcomes at discharge between the two groups was found, although hospital stay was longer in patients with symptomatic VTE (p=0.012). CONCLUSION: East Asian patients have a low incidence of symptomatic VTE after HFS, and the clinical outcomes of patients with symptomatic VTE were similar to patients without VTE, although there was a longer rehabilitation period.
Aged ; Aged, 80 and over ; Female ; Hip Fractures/*rehabilitation/*surgery ; Humans ; Male ; Postoperative Complications/etiology ; Retrospective Studies ; Treatment Outcome ; Venous Thromboembolism/*etiology

BACKGROUND: Intertrochanteric fractures of the femur are the most common type of fracture, and are an increasing occurrence due to the aging of the population. The objectives of our study are to predict the fate of intertrochanteric fractures treated with intramedullary hip nails by assessing the postoperative fracture stability utilizing the newly developed scoring system, and to help rehabilitate these patients. METHODS: Eighty-two patients with intertrochanteric fractures that were treated with intramedullary hip nails between December, 2004 and January, 2011 were subjected to this study. The patients who could be followed for a minimum of one year postoperatively were enrolled. The immediate postoperative conditions were determined by radiograms: reduction status (3 parameters/4 points: contact accuracy of posteromedial cortex, severity of angulation, and distraction), fixation status (3 parameters/3 points: tip-apex distance, location of tip of the lag screw, entry point of the intramedullary nail), and fracture type (1 parameter/1 point: stable or unstable type by the Kyle's classification). Postoperative reduction loss and fixation failure were checked by radiograms taken at a minimum 3 months postoperative. RESULTS: Reduction loss and fixation failure were observed in 14 consecutive patients (17%). The fixation failure rate was 100% (2 patients) in score 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8 patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups. There were fixation failures only in 1 out of 13 patients with score 5, and in 1 out of 18 patients with score 6. There was no fixation failure in 17 patients with score 7 and 11 patients with score 8. CONCLUSIONS: Maintenance of the fracture reduction by the stable fixation in the patient scores over 5 could be predicted by the postoperative radiograms.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Early Ambulation ; Female ; Femur/surgery ; Fracture Fixation, Intramedullary ; Health Status Indicators ; Hip Fractures/classification/rehabilitation/*surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Treatment Outcome

Aged ; Aged, 80 and over ; Bone Nails ; Bone Screws ; Exercise Therapy ; Female ; Femoral Neck Fractures ; physiopathology ; rehabilitation ; surgery ; therapy ; Fracture Fixation, Internal ; methods ; Hip ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function

OBJECTIVETo investigate the influence of hip and pelvic fracture, especially acetabular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury.

METHODSFrom January 1987 to January 2000, 17 patients (14 male and 3 female) who had hip and pelvic fractures complicated by sciatic nerve injury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years. The average age was 38 years (ranging 23-56 years). The left extremities were involved in 11 patients and the right in 6. Twelve patients underwent primary exploration and neurolysis and 5 patients underwent secondary operation.

RESULTSPreoperatively, 8 patients were treated with large doses of oral narcotics to control their severe sciatic pain. Three of the 8 patients underwent patient-controlled analgesia and epidural analgesia. After operation, excellent and good rates of reduction and functional recovery of sciatic nerve were 94.1% and 88% respectively. Four patients still had sciatic pain and 2 patients failed to recover. Sciatic nerve function improved within 3-6 months after surgery in 11 patients.

CONCLUSIONSHip and pelvic fractures can result in sciatic nerve injury, especially common peroneal nerve injury and prognosis is poor. Open reduction and internal fixation combined with nerve exploration and neurolysis should be used as early as possible for severe sciatic pain.

Adult ; Analgesics ; therapeutic use ; Cohort Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; rehabilitation ; Hip Fractures ; complications ; diagnostic imaging ; surgery ; Humans ; Intraoperative Complications ; Joint Dislocations ; complications ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Multiple Trauma ; diagnostic imaging ; rehabilitation ; surgery ; Pain Measurement ; Pelvic Bones ; injuries ; surgery ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Sciatic Nerve ; injuries ; Sciatic Neuropathy ; complications ; diagnosis ; drug therapy ; Treatment Outcome