Intertrochanteric fractures disable further the already incapacitated elderly patients. Intertrochanteric fractures increases the morbitity and mortality chances in elderly patients because of lack of mobility.(1,2) Intertrochanteric fractures has become a more common problem in elderly patients because of increased life expectancy and osteoporosis.(3,4) Aim of the treatment should be to mobilize these patients early. To achieve this anatomical reduction of comminuted fracture and stable fixation by PFN will restore the neck shaft angle and preserve patients hip joint, which gives lesser pain ,patients will walk better postoperatively, thus patients can be rehabilitated better and early. Because of some demeritis of PFN, hemiarthroplasty
Ankle sprains have three degrees of injury ranging from 1-3. The level of the ankle sprain is determined by the amount that the ligament is torn or stretched. A grade one sprain is categorized as a slight stretching and damage to the fibers of the ligament. A grade 2 sprain is characterized as partial tearing of the ligament and abnormal laxity of the ankle. A grade 3 sprain is characterized by complete tear of the ligament if it can be pushed or pulled in certain movements there is gross instability. The movements of the ankle are abduction, adduction, plantar flexion, dorsiflexion, and inversion, eversion. The ligaments of the ankle hold the ankle bones and joint into position. These ligaments protect the ankle joint from abnormal movements such as twisting, turning, and rolling of the foot.
The etiology of calcaneal fracture is usually high energy trauma such as fall from a height or motor vehicle crash 1,2.
The anatomy of the knee contains the femur, tibia and the patella. There are four main ligaments within the knee. Those ligaments are called medial collateral (mcl), lateral collateral (lcl), anterior cruciate (acl) and posterior cruciate (pcl). The anterior cruciate ligament (acl) is in the middle of the knee and prevents the shin from sliding. An anterior cruciate ligament tear is the most common harmed ligament, undergoing an estimate of 200,000 happenings yearly. Typically individuals who play sports such as football, basketball, skiing or soccer experience this injury.
Journal of chiropractic medicine. Volume 11, Issue 1:58-63. Papa J. 2012. The. Conservative management of lumbar compression fracture in an osteoporotic patient: a case report.
A femoral head preserving operation having satisfactory results in long term follow up should be the treatment of choice in younger individuals and THR in elderly where femoral head is badly damaged and in younger patients with multisystem diseases and poor general health. Considering the life style of people of our country who needs squatting habit, decompression of femoral head and TFL muscle pedicle bone grafting is a good option both in early and even in advanced stages of the disease unless the femoral head is badly deformed or collapsed more than 5mm. Considering its technical simplicity compared to the use of other vascularised bone grafts like vascularised fibular or vascular pedicle iliac crest graft, the above method can be recommended in patients of developing countries like ours where osteonecrosis is common.
There are many identifiable risk factors that are both modifiable, and non-modifiable. The gender of the patient is a major risk factor, as women are more likely to develop osteoporosis. Of the almost 50 million Americans diagnosed with osteoporosis, 80% are women. Females at any age have less bone density than males, but in the mid-30's women experience bone loss at a rate of 1% each year (Berarducci, 2008). Walker (2010) adds to the previous statistics, citing around one out of three women over the age of fifty will have a fracture related to osteoporosis, compared to one in 12 men.
Kyphoplasty- procedure where a balloon is inserted into the vertebrae and covered by cement, it elevates the fracture.
The meniscus is one of the most commonly injured structures in the knee. Meniscal injuries can occur in any age group, but causes are somewhat different for each age group. In younger people, the meniscus is fairly tough and rubbery, and tears usually occur as a result of a fairly forceful twisting injury. In the younger age group, meniscal tears are more likely to be caused by athletic activity (Sutton, 1999).
Thus, the recommended treatment for a patient with osteoporosis would receive supplementary calcium (1,000 to 1,500 mg of calcium daily) as confirmed in the National Institutes of Health Consensus Development Conference on osteoporosis in 1984. But studies have shown that as humans age their ability to absorb calcium starts to diminish making this treatment almost ineffective in some elderly patients. Patients of this time, with little treatment options were forced to endure many fracture related injuries; most commonly fractures of the hip which is a very complicated fracture requiring hospitalisation and a surgical practice would be required. Even if the surgery had been successful the patient would not be able to return to the previous levels of activity they were once at; forcing the patient from self-care to supervised living situations/nursing
"Chapter 37." Operative Techniques in Orthopaedic Surgery. Ed. Sam Wiesel. 4th ed. Vol. 2. Lippincott Williams & Wilkins, 2011. eBook.
Zhang Y, Wang X. (1994). 56 cases of disturbance in small articulations of the lumbar vertebrae treated by puncturing the effective points- a new system of acupunctue.Journal of Traditional Chinese Medicine, 14(2), 115-20.
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
In addition to financial cost, osteoporosis is a burdensome disease because it often results in injury, which leads to immobility, depression, and infection risk. Considering the targeted population for osteoporosis, immobility is very debilitating because it affects activities of daily living. When individuals are positions where they are unable to care for themselves, they are at risk for depression. Often times, elderly individuals lack family support when they need assistance at home. With a lack of help available, individuals are placed in nursing homes or left alone to struggle independently. When individuals are victims to fractures, hospital visits are sometimes required in the event surgery is performed. Considering the age of most patients, they are susceptible to infections if not properly cared for after surgery.
This Preusser (2008) case study involves a 75 year old female, S.P., who fell at home and is admitted to the orthopedic ward for an intracapsular fracture of the hip at the femoral neck (p. 183). Assessment data includes her height is 5’3”, weight is 118 lbs, blood pressure...
The tibial plateau is one of the most important load bearing areas in the body. Fractures of the medial or lateral condyles of the proximal tibia have a profound effect on stability and motion, and also affect the knee joint despite supporting ligaments being usually unaffected. Fractures of the tibial plateau in older people are commonly due to low energy trauma to osteoporotic bone resulting in a depressed fracture. In younger people, fractures may occur as a result of a high-energy valgus force on the leg with axial loading, most commonly following a road traffic accident. Tibial plateau fractures are characterised using the Schatzker classification system, which describes six types of fracture differing in complexity and in the extent of involvement of the medial plateau.