Características epidemiológicas y clínicas de las fracturas de cadera en adultos mayores en un hospital público chileno: Experience in 647 Chilean patients aged 60 years or more / Hip fracture

Background: Hip fractures (HFx) are an important geriatric syndrome, with a high incidence in developing countries. Aim: To describe characteristics of a group of Chilean patients with HFx. Patients and Methods: In a cross-sectional study we included patients aged 60 years or more with a HF admitted to an orthopedic service along three years. Age, incidence, location, seasonality, hospital stay, time between HFx and surgery, mortality, prior treatment for osteoporosis, anatomical location, etiology and type of surgery were evaluated. Results: We reviewed 647 patients with a median age of 81 years (76% women). The calculated incidence of hip fracture for people aged ≥ 65 years was 177/100,000. Sixty six percent of fractures were extracapsular. Mean hospital stay was 17 days and the mean lapse between the fracture and surgery was 19 days. Eighty four percent of patients had osteoporosis and only 5% were receiving treatment. Eighty three percent of patients were operated. Osteosynthesis was mainly used for extracapsular fractures and arthroplasty for intracapsular lesions. Intracapsular HFx tended to occur more commonly during warm seasons (Odds ratio = 1.534). Mortality at one year was 24%. It was higher among non-operated patients in whom the proportion of males and number of comorbidities were significantly higher. Conclusions: A high proportion of patients with HFx have osteoporosis albeit a reduced number is receiving treatment. Non-operated patients had a higher risk profile and higher mortality.

Picnodisostosis y fractura femoral: reporte y seguimiento a 2 años / Pycnodysostosis and femoral fracture: report and two-year follow-up

La Picnodisostosis consiste en un raro trastorno genético caracterizado por esclerosis ósea sistémica, cuya fisiopatología se debe a una deficiencia catepsina K, enzima esencial en la remodelación ósea. El problema ortópedico más importante en esta condición son las fracturas recurrentes de los huesos largos. Clínicamente se presenta con osteoesclerosis, talla baja, acroosteolisis de falanges distales, displasias ungueales, displasia clavicular, deformidades craneales secundarias al retardo en el cierre de suturas y fontanelas; miembros cortos, micrognatia, maxilar superior obtuso e inferior aplanado, retraso en la aparición de los dientes; y fragilidad ósea con tendencia a las fracturas. Se presenta caso de mujer de 27 años con Picnodisostosis, en control en Servicio de Traumatología Adulto Hospital Gustavo Fricke. Damos a conocer su historia clínica, desde el diagnóstico de su enfermedad, hasta las complicaciones y tratamientos ortopédicos y quirúrgicos de sus fracturas recurrentes...

Pycnodysostosis is an uncommon genetic malformation characterized by systemic bone sclerosis, whose pathophysiologyis due to essential enzyme deficiency in bone remolding, cathepsin K. The most relevant orthopedic problems of this condition are the recurrent long-bones fractures. A clinical case is presented: 27 year old, female patient controlling at the Adult Traumatology Service in Hospital Gustavo Fricke. We present her clinical story from diagnose to the fracture’s complications and treatments, orthopedic and surgical...