M I Parker

..To present the updated results of systematic review of the current evidence for the effectiveness of hip protectors from reports of completed randomised trials, and to explore the evolution of that evidence...

..The functional recovery at patients at 1 year was excellent. The results to date for this new implant suggest that it may lead to reduced fracture-healing complications in comparison to the currently used methods of internal fixation...

..38). There was a statistically significant increase in the proportion of patients who had more than two urinary catheterisations (6/18 versus 3/36, P=0.05) or who had a long-term catheter (7/16 versus 3/36, P=0.01) in the sepsis group...

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..Six were managed with an arthroplasty and four treated conservatively. At 1-year from injury 29% of patients had died. For the survivors 87% were able to return home and only 6% had significant residual pain...

..In external fixators, the stabilising component is held outside the thigh by pins or screws driven into the bone. This is an update of a Cochrane review first published in 1998, and last updated in 2005...

..The smooth tapered stem was felt to present less operative difficulties compared to the Thompson prosthesis. There were no other statistically significant differences in outcomes between the two prostheses...

..01 at one year from injury). In summary, both implants produced comparable results but there was a tendency to better return of mobility for those treated with the intramedullary nail...

..Following a hip fracture, traction may be applied to the injured limb before surgery...

..Intramedullary nails may be used for the surgical fixation of extracapsular hip fractures in adults. They may be inserted from the top (cephalocondylic) or from the bottom (condylocephalic) end of the femur...

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..These results demonstrate that both treatment methods produce comparable final outcomes but internal fixation is associated with an increased re-operation rate...

..Our study showed an increased risk for intracapsular hip fractures developing nonunion with older age and in females...

..2%) of operations. The difference in survival of patients related to the primary tumour site is of relevance in planning surgical treatment and discussing prognosis with patients...

..Various radiographic features of the fracture have been used to estimate the risk of fracture healing complications...

..The evidence base for this practice is limited. To determine if oral iron therapy is beneficial for the treatment of anemia after surgery for the treatment of a hip fracture, we undertook a prospective, randomized controlled trial...

..The use of a cemented Thompson hemiarthroplasty resulted in less pain and less deterioration in mobility than an uncemented Austin-Moore prosthesis with no increase in complications...

..None of these differences between groups was statistically significant. In summary there is no difference in fracture healing complications related to the length of the screw threads...

..Delaying surgery whilst waiting for the INR to fall to acceptable levels may result in significant delays to surgery and we would recommend a more aggressive policy to enable earlier surgery...

..Our aim was to analyse outcomes following such fractures with reference to influence of fracture displacement, timing of surgery and method of reduction (open/closed) on the incidence of non-union (NU) and avascular necrosis (AVN)...

..There was no significant difference in patient characteristics between the winter and summer seasons. Funding and resources within the health service may need to be adjusted to accommodate this variation in patient load...

..The final outcome of surgery for the survivors is good, with most patients returning to their pre-fracture level of accommodation and mobility, with minimal pain 1-year post-fracture...

..Following surgery almost all patients should be allowed to mobilize without any restrictions on weight bearing or hip movements...

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..We recommend that when inserting an Austin Moore hemiarthroplasty, particular attention must be paid to the seating of the collar of the prosthesis on the calcar and correct choice of head size...

..Neither the Jensen classification nor the AO classification with subgroups is an acceptable classification system for trochanteric hip fractures...

..The next step is to find ways of using these indicators to promote real improvement in the care of these patients...

..After adjustment for surgical approach and the use of cement there was no difference in risk of dislocation between unipolar and bipolar hemiarthroplasties. There was an increased risk of open reduction for a bipolar hemiarthroplasty...

..For the 16 fractures treated by internal fixation without any attempt at fracture reduction, fracture healing occurred in 11 cases...

..CONCLUSION: This fracture pattern is a challenge for the orthopaedic surgeon with a high risk of fracture healing complications. The 135 degrees SHS and the intramedullary devices had similar failure rates...

..Of the remainder, 111/177 (62.7%) stated they were taking therapy to reduce the risk of fractures. These results demonstrate that an aggressive policy of prescribing can result in good levels of compliance with therapy...

..For the frail elderly with a displaced intracapsular fracture this prosthesis can still be recommended. This paper presents the largest consecutive series, with the longest follow-up, currently available...

..The different mortality between centres (30 versus 36%) was not statistically significant when adjusted for the possible confounding factors...