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Diagnostics
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Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management
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Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 8528

Special Issue Editors

Prof. Dr. Harald Kurt Widhalm

E-Mail Website1 Website2 Website3
Guest Editor
Clinical Division of Traumatology, Department of Orthopedics and Traumatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
Interests: orthopedic surgery; arthroplasty; knee joint; traumatology; cartilage; orthopedic sports medicine; trauma; fracture; emergency medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Nikolaus W. Lang

E-Mail Website
Guest Editor
Consultant for Orthopaedics & Traumatology, Medical University of Vienna, Department of Orthopaedics and Trauma Surgery, General Hospital Vienna, Waehringer Guertel 18-20 A-1090 Vienna, Austria
Interests: orthopedic surgery; arthroplasty; knee joint; traumatology; cartilage; orthopedic sports medicine; trauma; fracture; emergency medicine

Special Issue Information

Dear Colleagues，

As the average life expectancy has increased over the last decades, doctors now often have to provide care for patients who suffer from several comorbidities. When treating fractures, especially geriatric traumatic hip fractures, the greatest challenges for physicians are the appropriate preparation of the patient for the operation, which often requires special examinations, the complication-free execution of the operation, as well as the management of osteoporotic bone conditions followed by initiation of a targeted rehabilitation. Often, surgical care has to be provided but, unfortunately, is followed by relatively high mortality rates in elderly patients.

To provide a high standard of care and lower mortality risks, it is crucial to individually address each patients’ needs. One diagnostic aspect that is easily accessed—but often underestimated in its importance—is correct and detailed imaging to allow precise planning of treatment strategies and surgical interventions.

To lower overall risks for patients, a gold standard for this process should be established. For this purpose, I cordially invite all authors to submit original articles on this topic.

Prof. Dr. Harald Kurt Widhalm
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • trauma
  • fractures
  • hip
  • diagnostics
  • treatment
  • osteosynthesis
  • imaging
  • emergency medicine
  • management

Published Papers (4 papers)

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Research

9 pages, 389 KiB  
Article
Days Alive and Out of Hospital at 15 Days after Hip Replacement May Be Associated with Long-Term Mortality: Observational Cohort Study
by Ah Ran Oh, Ji-Hye Kwon, Jungchan Park, Gayoung Jin, So Myung Kong and Sangmin Maria Lee
Diagnostics 2023, 13(6), 1155; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13061155 - 17 Mar 2023
Viewed by 789
Abstract
We aimed to evaluate the association between days alive and out of hospital (DAOH) and mortality at 15 days after a hip replacement. From March 2010 to June 2020, we identified 5369 consecutive adult patients undergoing hip replacements and estimated DAOH at 15, [...] Read more.
We aimed to evaluate the association between days alive and out of hospital (DAOH) and mortality at 15 days after a hip replacement. From March 2010 to June 2020, we identified 5369 consecutive adult patients undergoing hip replacements and estimated DAOH at 15, 30, 60, and 90 days after surgery. After excluding 13 patients who died within 15 days after surgery, receiver operating characteristic (ROC) curves were then generated to evaluate predictabilities for each follow-up period. We compared the mortality risk according to the estimated thresholds of DAOH at 15 days after hip replacement. ROC analysis revealed areas under the curve of 0.862, 0.877, 0.906, and 0.922 for DAOH at 15, 30, 60, and 90 days after surgery, respectively. The estimated threshold of DAOH during the 15 postoperative days was 6.5. Patients were divided according to this threshold, and propensity score matching was conducted. In a propensity score-matched population with 864 patients in each group, the risk of mortality increased in patients with a lower DAOH 15 (2.8% vs. 8.1%; hazard ratio [HR] = 3.96; 95% confidence interval [CI]: 2.24–6.99; p < 0.001 for one-year mortality, 5.2% vs. 13.0%; HR = 3.82; 95% CI: 2.33–6.28; p < 0.001 for three-year mortality, and 5.9% vs. 15.6%; HR = 3.07; 95% CI: 2.04–4.61; p < 0.001 for five-year mortality). In patients undergoing a hip replacement, DAOH at 15 days after surgery was shown to be associated with increased mortality. DAOH at 15 days may be used as a valid outcome measure for hip replacement. Full article
(This article belongs to the Special Issue Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management)
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12 pages, 2221 KiB  
Article
Microstructural and Strength Changes in Trabecular Bone in Elderly Patients with Type 2 Diabetes Mellitus
by Mercè Giner, Cristina Miranda, María Angeles Vázquez-Gámez, Patricia Altea-Manzano, María-José Miranda, Antonio Casado-Díaz, Ramón Pérez-Cano and María-José Montoya-García
Diagnostics 2021, 11(3), 577; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030577 - 23 Mar 2021
Cited by 7 | Viewed by 2647
Abstract
Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide and it is associated with an increased risk of osteoporosis and fragility fractures. Our aim is to analyze the effect of T2DM on bone quality. This is a case-control [...] Read more.
Type 2 diabetes mellitus (T2DM) is one of the most common chronic diseases worldwide and it is associated with an increased risk of osteoporosis and fragility fractures. Our aim is to analyze the effect of T2DM on bone quality. This is a case-control study. The studied population consisted of 140 patients: 54 subjects with hip fracture (OP) without T2DM, 36 patients with hip fracture and T2DM (OP-T2DM), 28 patients with osteoarthritis (OA) without T2DM, and 22 patients with OA and T2DM (OA-T2DM). Bone markers, bone mineral density, FRAX score, microstructural, and bone material strength from femoral heads were assessed. The group with hip fracture presented lower BMD values than OA (p < 0.05). The OP, OP-T2DM, and OA-T2DM groups showed a decrease in bone volume fraction (BV/TV), in trabecular number (Tb.N), and in trabecular thickness (Tb.Th), while an increase was presented in the structural model index (SMI) and trabecular bone pattern factor (Tb.Pf), The groups OP, OP-T2DM, and OA-T2DM also presented lower values than those in group OA regarding the biomechanical parameters in the form of Young’s modulus or elastic modulus, toughness, ultimate stress, ultimate load, extrinsic stiffness, and work to failure (p < 0.05). Our results show the negative effect of type 2 diabetes mellitus on trabecular bone structure and mechanical properties. Full article
(This article belongs to the Special Issue Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management)
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12 pages, 967 KiB  
Article
Predicting 30-Day and 180-Day Mortality in Elderly Proximal Hip Fracture Patients: Evaluation of 4 Risk Prediction Scores at a Level I Trauma Center
by Arastoo Nia, Domenik Popp, Georg Thalmann, Fabian Greiner, Natasa Jeremic, Robert Rus, Stefan Hajdu and Harald K. Widhalm
Diagnostics 2021, 11(3), 497; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030497 - 11 Mar 2021
Cited by 6 | Viewed by 1984
Abstract
This study evaluated the use of risk prediction models in estimating short- and mid-term mortality following proximal hip fracture in an elderly Austrian population. Data from 1101 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of [...] Read more.
This study evaluated the use of risk prediction models in estimating short- and mid-term mortality following proximal hip fracture in an elderly Austrian population. Data from 1101 patients who sustained a proximal hip fracture were retrospectively analyzed and applied to four models of interest: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), Charlson Comorbidity Index, Portsmouth-POSSUM and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) Risk Score. The performance of these models according to the risk prediction of short- and mid-term mortality was assessed with a receiver operating characteristic curve (ROC). The median age of participants was 83 years, and 69% were women. Six point one percent of patients were deceased by 30 days and 15.2% by 180 days postoperatively. There was no significant difference between the models; the ACS-NSQIP had the largest area under the receiver operating characteristic curve for within 30-day and 180-day mortality. Age, male gender, and hemoglobin (Hb) levels at admission <12.0 g/dL were identified as significant risk factors associated with a shorter time to death at 30 and 180 days postoperative (p < 0.001). Among the four scores, the ACS-NSQIP score could be best-suited clinically and showed the highest discriminative performance, although it was not specifically designed for the hip fracture population. Full article
(This article belongs to the Special Issue Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management)
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17 pages, 1968 KiB  
Article
Metal Ion Release, Clinical and Radiological Outcomes in Large Diameter Metal-on-Metal Total Hip Arthroplasty at Long-Term Follow-Up
by Assunta Pozzuoli, Antonio Berizzi, Alberto Crimì, Elisa Belluzzi, Anna Chiara Frigo, Giorgio De Conti, Annamaria Nicolli, Andrea Trevisan, Carlo Biz and Pietro Ruggieri
Diagnostics 2020, 10(11), 941; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics10110941 - 12 Nov 2020
Cited by 16 | Viewed by 2428
Abstract
Total hip arthroplasty (THA) with metal-on-metal (MoM) bearings have shown problems of biocompatibility linked to metal ion release at the local level causing an adverse reaction to metal debris (ARMD) and at a systemic level. The aim of this study was to evaluate [...] Read more.
Total hip arthroplasty (THA) with metal-on-metal (MoM) bearings have shown problems of biocompatibility linked to metal ion release at the local level causing an adverse reaction to metal debris (ARMD) and at a systemic level. The aim of this study was to evaluate clinical and radiological outcomes, and metal ion concentrations in the blood and urine of patients who underwent THA with the LIMA Met-Met hip system. Patients with ceramic-on-ceramic (CoC) bearings were included as a control group. In this study, 68 patients were enrolled: 34 with MoM THAs and 34 with CoC THAs. Patients were evaluated clinically (Harris Hip Score, SF-36) and radiologically at a median of 7.4 years after surgery. Whole blood and urinary cobalt and chromium levels were also assessed. Both types of implants were comparable in terms of clinical and functional results. Ion levels were significantly higher in the MoM group compared with CoC group 7 years after surgery. No correlations were found between metal ion levels and patient demographics, functional and radiological outcomes, and prosthesis features. Patient monitoring is thus advised to establish if prosthesis revision is necessary, especially in the case of MoM THA. Full article
(This article belongs to the Special Issue Geriatric, Traumatic Hip Fractures: Diagnosis, Treatment, and Management)
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