ABSTRACT
The aim of this study was to investigate the outcome of 352 (71 males) patients with trochanteric fractures that were treated with the TARGON® PF nail. The mean age was 83 years. According to the Jensen classification, there were 35 cases in type 1,94 cases in type 2,75 in type 3,63 in type 4 and 85 in type 5. Postoperative all patients were allowed to fully weight bear from the first postoperative day. Clinical and radiological data were collected at regular time intervals. The average waiting time to surgical reconstruction for the 352 cases was 3.5 days (1-7). The mean length of hospital stay was 14 days (5-22). The operative times ranged from 11 to 125 minutes with an average time of 32 minutes. Fifty percent of the patients regained their mobility to their pre-injury level at the final follow up. Out of 310 patients (88%) who were available for radiographie assessment, all fractures united except one case. 300 (85%) of the lag screws were placed in the inferior area in the anteroposterior view and in the central area in the lateral view (IM), which is regarded as the optimal position. The lag screws back-slided between 0 and 19 mms with an average of 6 mm. Sliding distance of the lag screw for over 10 mm was seen in 42 cases (13%). Varus collapse of the femoral head-and-neck greater than 10° was observed in 6 cases. Postoperative complications developed in 6 cases (1.7%), including wound infection in two cases, and secondary fracture at the subtrochanteric region, nonunion, back-out of the guiding sleeve and medial perforation of the lag screw, each in one case. The presented case series indicates that the TARGON® PF system is an effective and safe internal fixation device for trochanteric proximal femoral fractures. Further, prospective comparative evidence regarding the use of this system is needed to analyse and validate the presented clinical impression of our centre.
Subject(s)
Bone Nails , Bone Screws/adverse effects , Fracture Fixation, Intramedullary/methods , Hip Fractures/surgery , Adult , Aged , Aged, 80 and over , Female , Femur/surgery , Fracture Fixation, Intramedullary/adverse effects , Fracture Fixation, Intramedullary/instrumentation , Hip Fractures/classification , Hip Fractures/diagnostic imaging , Hip Joint/physiology , Hip Joint/surgery , Humans , Length of Stay , Male , Middle Aged , Postoperative Complications/epidemiology , Radiography , Recovery of Function , Treatment Outcome , Walking/physiology , Weight-BearingABSTRACT
UNLABELLED: Hirose J, Ide J, Yakushiji T, Abe Y, Nishida K, Maeda S, Anraku Y, Usuku K, Mizuta H. Prediction of postoperative ambulatory status 1 year after hip fracture surgery. OBJECTIVES: To assess the validity of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for predicting the postoperative risk and ambulatory status long-term follow-up after hip fracture surgery and to establish an algorithm for predicting their ambulatory status. DESIGN: Cohort study. SETTING: Twelve hospitals belonging to the regional network for hip fracture in Japan. PARTICIPANTS: The study population was composed of 421 patients; 268 underwent surgery between April 2004 and March 2006 (group A), and 153 were treated surgically between April 2006 and March 2007 (group B). All were operated at 3 surgical hospitals and, subsequently, transferred to 9 rehabilitation centers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We evaluated various factors, including their E-PASS scores to determine whether there was a correlation with the patients' mortality rate and their ability to walk at discharge and 1 year after surgery (group A). Using multiple regression analysis, we then developed algorithms to predict the ability of elderly patients to walk after hip fracture surgery. We applied the algorithms to group B patients and compared their actual and predicted ambulatory status. RESULTS: In group A patients, the postoperative walking ability and mortality rate were highly correlated with their E-PASS scores and dementia status. In group B, our algorithms exhibited good correlations between the predicted and actual walking ability at both time points (rho=0.6, P<.001). CONCLUSIONS: In candidates for hip fracture surgery, the E-PASS scores exhibited a good correlation with the patients' functional and survival prognoses, and the algorithm including E-PASS scores and dementia status can accurately estimate the ambulatory status at discharge and 1 year after surgery.
Subject(s)
Hip Fractures/mortality , Hip Fractures/physiopathology , Walking , Age Factors , Aged , Aged, 80 and over , Algorithms , Cohort Studies , Dementia/complications , Female , Hip Fractures/complications , Hip Fractures/surgery , Humans , Length of Stay , Male , Middle Aged , Postoperative Period , Prognosis , Regression Analysis , Sex FactorsABSTRACT
The purpose of this study was to examine the influence of the member's life in destructive cults on the psychological problems after departing from the groups. A factor analysis was performed with the data of questionnaires toward 157 participants, and seven factors were extracted. They were (1) avoidance behavior to avoid out-groups, (2) restriction of freedom, (3) satisfaction, (4) behavior of submission, (5) compliance with rules, (6) punishment and reward, and (7) mysterious experience. Analyses of variance showed that restriction of freedom and punishment and reward are more likely to develop personal distress, whereas mysterious experiences are more likely to develop personal distress and interpersonal distress.
