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2019, Number 6

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Rev Fac Med UNAM 2019; 62 (6)

Hip Fracture in Elderly Patients: The Impact of Timely Surgical Treatment in Morbimortality

Zaragoza SD, González LJ, King MAC
Full text How to cite this article

Language: Spanish
References: 8
Page: 28-31
PDF size: 358.78 Kb.


Key words:

Hip fracture, morbidity, mortality, surgical treatment.

ABSTRACT

Introduction: Hip fracture, may occur in the femoral head, neck or in the intertrochanteric line. It is one of the most important causes of morbidity and mortality in elderly pa tients and it affects the physical, mental, functional and social equilibrium of these patients.
Up to 50% of patients with hip fracture die in the first six months after the injury and many those who survive don´t recover their previous level of independence and functionality.
Early surgical resolution diminishes mortality and complications. Every two days that the surgery is postponed doubles the risk of death.
Case report study: A 74-year-old female patient who presented a fall from her own height, is rendered incapable of walking and presents progressive pain in her right hip. She consults an orthopedic doctor for examination 42 days after the fall. Physical examination: right pelvic lower limb with an external rotation and a 1 cm shortness, hip mobility arches limited by pain. Muscle group strength was not examined because of the pain. An AP x-ray of the pelvis was performed that showed a simple trace at subcapital level on the right hip.
A total arthroplasty of the right hip was performed 52 days after the patient’s fall.
Conclusions: Hip fracture is a common problem in elderly patients and is associated with a high morbimortality. It is important to handle these cases early to diminish the risk of complications and mortality.


REFERENCES

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  2. Kim Edward L, Herbert LM, Leanne LL. Hip Fracture: Diagnosis, Treatment, and Secondary Prevention. American Family Physician Am Fam Physician. 2014 Jun 15;89(12):945-51.

  3. Sobolev B, Guy P, Sheehan KJ, et al. Mortality effects of timing alternatives for hip fracture surgery. CMAJ. 2018;190(31):923-30. doi: 10.1503/cmaj.171512

  4. Fernández MA, Griffin XL, Costa ML. Management of hip fracture. Br Med Bull. 2015 Sep;115(1):165-72. doi: 10.1093/bmb/ldv036. Epub 2015 Aug 26.

  5. Negrete Corona J, Alvarado Soriano JC, Reyes Santiago LA. Fractura de cadera como factor de riesgo en la mortalidad en pacientes mayores de 65 años. Estudio de Casos y controles. Acta Ortopédica Mexicana. 2014;28(6):352-62. Disponible en: http://www.medigraphic.com/actaortopedica

  6. Desai SJ, Patel J, Abdo H, Lawendy AR, Sanders D. A comparison of surgical delays in directly admitted versus transferred patients with hip fractures: opportunities for improvement? Can J Surg. 2014;57(1):40-3. doi:10.1503/ cjs.002613

  7. Pincus D, Wasserstein D, Ravi B, et al. Reporting and evaluating wait times for urgent hip fracture surgery in Ontario, Canada. CMAJ. 2018;190(23):E702-E709. doi:10.1503/ cmaj.170830

  8. Sobolev B, Guy P, Sheehan KJ, et al. Mortality effects of timing alternatives for hip fracture surgery. CMAJ. 2018;190(31):E923-E932. doi:10.1503/cmaj.171512




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Rev Fac Med UNAM . 2019;62