Predictors for Ambulatory Recovery after Fixation of Intertrochanteric Fracture with Proximal Femoral Nail in the Elderly / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare with general characteristics affecting ambulatory recovery at one-year after the fixation of intertrochanteric fracture with proximal femoral nail (PFN) of elderly patients over the age of 65 years. MATERIALS AND METHODS: Between September 2008 and September 2015, 152 patients were diagnosed with femoral intertrochanteric fracture in Dong-Eui Medical Center. Of these patients, 75 were available in this retrospective study. Multivariate linear regression analysis, using a stepwise selection method, were performed to identify the prognostic factors affecting one-year postoperative recovery of ambulatory status, such as pre-injury ambulatory status, gender, age, fracture type, associated underlying disease, American Society of Anesthesiologists (ASA) grade, dementia, and complication. RESULTS: A decrease in the one-year postoperative ambulatory status was 68% and pre-injury ambulatory status was regained in 32% of patients. The pre-injury ambulatory status was the most important determinant of one-year postoperative recovery of ambulatory status. The ASA grade and complication were also predictors of recovery of ambulatory status. CONCLUSION: Pre-injury ambulatory status, ASA grade and complication were prognostic factors associated with one-year postoperative recovery of ambulatory status after fixating the intertrochanteric fracture using PFN in elderly patients over the age of 65 years.

Ossification of the Coracoacromial Ligament in Subacromial Impingement Syndrome: A Case Report

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.

Ossification of the Coracoacromial Ligament in Subacromial Impingement Syndrome: A Case Report

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.

The Influence of Stroke on Postoperative Prognosis of Femoral Intertrochanteric Fractures / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to compare the general characteristics that affect the prognosis and evaluate the influence of stroke on one-year postoperative mortality and recovery of ambulatory status in elderly patients over 65 years old with femoral intertrochanteric fracture. MATERIALS AND METHODS: This study included 80 patients who were followed-up for one year after proximal femoral nailing for femur intertrochanteric fracture between January 2008 and December 2013. We analyzed the relationship among the one-year postoperative mortality, recovery of ambulatory status and the associated factors (age, gender, associated underlying disease, American Society of Anesthesiologists [ASA] grade, comminution of the fracture, dementia). RESULTS: The one-year postoperative mortality rate in all patients and patients with stroke was 28.8% and 42.9%, respectively. The one-year postoperative mortality rate was significantly higher in patients with stroke, high ASA grade, and unstable fracture. Decrease of the one-year postoperative ambulatory status was 50.9% in all patients and was significantly associated with grade III or IV ASA rating. No significant relationships were observed between the one-year postoperative recovery of ambulatory status and stroke. CONCLUSION: Stroke, ASA grade, and unstable fracture were prognostic factors associated with one-year postoperative mortality following intertrochanteric fracture. ASA rating was the only prognostic factor affecting one-year postoperative recovery of ambulatory status.