Increased mortality among patients sustaining hip fractures requiring surgery in a district general hospital.

Fractures of the femoral neck are a common condition the incidence of which continues to rise. Associated mortality remains very high and knowledge of factors contributing to this high mortality is crucial in understanding outcome for both patient and surgeon. A retrospective review of 1254 patients operated on for fracture neck of femur was conducted to identify mortality at 30 days, 90 days and one year. Age, type of fracture, sex and waiting time for surgery were evaluated along with mortality for 47 patients who sustained their fracture while already inpatients with other concurrent illnesses. Those patients who sustained an inpatient fracture were found to have significantly higher mortality at 30 days, 90 days and one year. We concluded that these patients represent a very high-risk group that needs special consideration in management of their fracture and concurrent medical condition to reduce their high mortality.

Fracture of the polyethylene tibial post in posterior stabilized (Insall Burstein II) total knee arthroplasty.

Polyethylene wear is a well-recognized complication of total knee arthroplasty (TKA). To our knowledge, fracture of the polyethylene tibial post in a posterior stabilized TKA system has not been described as a complication or cause of failure in TKA. We report a case of a fractured polyethylene tibial post in an 85-year-old woman within 3 years of Insall Burstein II TKA, causing instability that necessitated revision surgery.