Journal of Musculoskeletal Trauma

Original Articles

Risk Factors of Postoperative Delirium in Elderly Patients with Hip Fractures: Ki Hwan Kim, Duk Hwan Kho, Ju Yong Shin, Jin Yong Choi, Eung Sik Kim, Dong Heon Kim; J Korean Fract Soc 2008;21(3):189-194. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.189

PURPOSE
To find out the relationship between various risk factors and post-operative delirium in elderly patients with hip fractures.
MATERIALS AND METHODS
Out of 135 patients older than 65 years old who underwent the surgery for hip fracture in our department, between the periods of March 2003 to March 2005, 14 patients (10.4%) developed post-operative delirium and 121 patients (89.6%) did not. We studied risk factors of post-operative delirium in two groups.
RESULTS
In chi-square test between delirium group and non-delirium group, the patients were more likely to develop post-operative delirium if they had previous episodes of delirium, abnormal cognitive function, low walking ability before admission, high dependency on ADL (Activities of Daily Living), other medical accompanying diseases, history of dementia, post-operative hypoxia, post-operative electrolyte imbalance, low post-operative hemoglobin and hematocrit, low post-operative albumin and were older than 75 years old (p<0.05). Sex, type of fracture, anesthesia and the time between admission and operation did not show much difference between the two groups.
CONCLUSION
The risk factors of postoperative delirium in elderly patients with hip fracture have a tendency to be multifactorial. Therefore, we conclude that being prepared by thorough understanding of the risk factors and their relationships will help prevent post-operative delirium and result in good postoperative prognosis.

Citations

Citations to this article as recorded by

Increased Serum Neuropeptide Galanin Level Is a Predictor of Cognitive Dysfunction in Patients with Hip Fracture
Zichao Xue, Ke Zhang, Biao Luo, Long Fan, Ruizhe Zhao, Guangliang Hu, Yuzhen Xu
Disease Markers.2021; 2021: 1. CrossRef
Sleep Disturbance Strongly Related to the Development of Postoperative Delirium in Proximal Femoral Fracture Patients Aged 60 or Older
Myung-Rae Cho, Suk-Kyoon Song, Cheol-Hwan Ryu
Hip & Pelvis.2020; 32(2): 93. CrossRef
Incidence and Associated Factors of Delirium after Orthopedic Surgery
Si-Wook Lee, Chul-Hyun Cho, Ki-Cheor Bae, Kyung-Jae Lee, Eun-Seok Son, Sang-Hyun Um
Journal of the Korean Orthopaedic Association.2019; 54(2): 157. CrossRef
Relationship between Delirium and Clinical Prognosis among Older Patients underwent Femur Fracture Surgery
Jae-Lan Shim, Seon-Young Hwang
Journal of the Korea Academia-Industrial cooperation Society.2016; 17(2): 649. CrossRef
Relationship between Knowledge, Stress, and Nursing Performance about Care for Delirium in Geriatric Hospital Nurses
Eun-Hee Kim
Journal of Korean Clinical Health Science.2016; 4(2): 593. CrossRef
The effects of a tailored intensive care unit delirium prevention protocol: A randomized controlled trial
Kyoung-Ja Moon, Sun-Mi Lee
International Journal of Nursing Studies.2015; 52(9): 1423. CrossRef
Is Delirium an Unrecognized Threat to Patient Safety in Korean Intensive Care Units?
Kyoung-Ja Moon, Jinshi Piao, Yinji Jin, Sun-Mi Lee
Journal of Nursing Care Quality.2014; 29(1): 91. CrossRef
The Effects of Delirium Care Training Program for Nurses in Hospital Nursing Units
Moonja Kim, Haejung Lee
Korean Journal of Adult Nursing.2014; 26(5): 489. CrossRef
Knowledge, Performance and Stress about Care for Delirium in Orthopedic Hospital Nurses
Mi Young Kim, Young Eun
Journal of muscle and joint health.2013; 20(1): 72. CrossRef
The Experience of Delirium Care and Clinical Feasibility of the CAM-ICU in a Korean ICU
Joo-Hee Jung, Jung-Hye Lim, Eun-Jung Kim, Hyo-Chan An, Min-Kyung Kang, Jin Lee, Yu-Kyung Min, Eun-Zoo Park, Xiang-Hwa Song, Hye-Ryoung Kim, Sun-Mi Lee
Clinical Nursing Research.2013; 22(1): 95. CrossRef
Development and validation of the Korean Nursing Delirium Scale
Kyoung-Nam Kim, Cheol-Ho Kim, Kwang-Il Kim, Hyun-Jung Yoo, Si-Young Park, Yeon-Hwan Park
Journal of Korean Academy of Nursing.2012; 42(3): 414. CrossRef
Influencing Factors of the Incidence of Delirium in Elderly Patients with Arthroplasty
Young-Whee Lee, Hye-Bin Im, Eun-Jeong Jeong, Hee-Sun Ma
Korean Journal of Adult Nursing.2012; 24(4): 348. CrossRef
Delirium After Spinal Surgery in Korean Population
Jin Kyu Lee, Ye-Soo Park
Spine.2010; 35(18): 1729. CrossRef
The Incidence and Related Factors of Delirium in Elderly Patients with Hip Fracture after Surgery
Bo-Kyung Sohn, Yerl-Bo Sung, Eun-Jin Park, Dong-Woo Lee
Journal of the Korean Geriatrics Society.2010; 14(3): 162. CrossRef

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Trochanteric Management for Unstable Intertrochanteric Femoral Fracture in the Elderly Patients: Duk Hwan Kho, Ju Yong Shin, Ki Hwan Kim, Jun Hyuck Lee, Dong Heon Kim; J Korean Fract Soc 2007;20(2):129-134. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.129

Abstract PDF

PURPOSE
To evaluate the results after fixation with figure of eight and cerclage wiring for comminuted trochanteric fracture. Because comminution of the femoral trochanteric fracture in elderly patients is severer in the operating field than x-ray findings, so the fixation is more difficult.
MATERIALS AND METHODS
Between March 1998 and March 2004, the clinical records on twenty-eight patients more than 70 years old who underwent the bipolar hemiarthroplaty using calcar replacement type of femoral stem and followed more than 24 months were reviewed. Figure of eight and cerclage wiring was used for the comminuted trochanteric fracture of the femoral intertrochanteric fracture. The mean age was 80.4 (70~103) years. 19 cases were female, 9 cases were male. Mean follow-up period was 58 (24~92) months. We evaluated the results by modified Harris hip score, walking ability, activity of daily living, radiologic findings and union of the fracture.
RESULTS
The mean duration of bony union was 12 weeks. The mean postoperative modified Harris hip score was 82.3. Preoperative walking ability was recovered in 23 cases (82%). Also basic activity of daily living was recovered in 22 cases (79%). Nonunion of trochanter was found in only one case by radiologic evaluation but clinical correlation was not significant.
CONCLUSION
We consider fixation with figure of eight and cerclage wiring for unstable intertrochanteric fracture of femur in the elderly patient is more appropriate in terms of convenience of fixation, duration of union, early ambulation and cost effectiveness.

Citations

Citations to this article as recorded by

Outcomes of dynamic hip screw augmented with trochanteric wiring for treatment of unstable type A2 intertrochanteric femur fractures
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
Injury.2017; 48: S72. CrossRef
Fixation of Greater Trochanter Using an AO Trochanteric Reattachment Device (AO TRD) in Arthroplasty for Intertrochanteric Femur Fracture of Elderly Patients
Weon-Yoo Kim, Young-Yul Kim, Jae-Jung Jeong, Do-Joon Kang
Hip & Pelvis.2013; 25(4): 274. CrossRef
Bipolar Hemiarthroplasty Using the Greater Trochanter Reattachment Device (GTRD) for Comminuted Intertrochanteric Femur Fracture in Elderly Patients
Jin-Wan Kim, Young-Chul Ko, Chul-Young Jung, Il-Soo Eun, Hyeon-Soo Choi, Ok-Gul Kim, Young-June Kim
Journal of the Korean Fracture Society.2009; 22(4): 232. CrossRef

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Treatment of the Hip Fracture in Elderly Patients with Cerebrovascular Accident (CVA): Ki Hwan Kim, Duk Hwan Kho, Ju Yong Shin, Dong Heon Kim, Jun Hyuck Lee; J Korean Fract Soc 2006;19(2):122-127. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.122

Abstract: PURPOSE
To evaluate the results of the treatment of the hip fractures in elderly hemiplegic CVA patients with disuse osteoporosis. Hemiplegic CVA patients have much difficulties in rehabilitation such as walking, daily activity of living and so forth.
MATERIALS AND METHODS
The clinical records on thirty-four CVA patients who had undergone the treatment in hip fracture and followed more than 12 months of period between March 1998 and March 2004 were retrospectively reviewed. The treatment methods were 22 cases of bipolar hemiarthroplasty, 6 cases of compression hip screw, 3 cases of ender nail, 3 cases of multiple cannulated screw. We compared the groups underwent bipolar hemiarthroplasty (Group I), internal fixation (Group II), fracture in ipsilateral (Group A), fracture in contralateral (Group B). We evaluated the results by modified Harris hip score, walker ambulation time, walking ability and activity of daily living.
RESULTS
The mean postoperative modified Harris hip score was decreased in Group I (11.7 points), Group II (9.6 points), Group A (10.0 points), Group B (12.3 points). Recovery of preoperative walking ability was achieved in total 21 cases (62%) that 7 cases (58%) were observed in Group I, 14 cases (64%) in Group II, 18 cases (67%) in Group A and 3 cases (43%) in Group B. Basic activity of daily living was possible in 18 cases (53%).
CONCLUSION
Hemiplegic CVA patients with hip fracture have much difficulties in rehabilitation. However, with appropriate treatment and confident positive attitude for rehabilitations of the patients, doctors and family members, we can expect more reliable results close to the pre-injury status in terms of walking ability and activity of daily living.

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Postoperative Mortality Rate of Hip Fracture in Elderly Patients: Duk Hwan Kho, Ki Hwan Kim, Ju Yong Shin, Jun Hyuck Lee, Dong Heon Kim; J Korean Fract Soc 2006;19(2):117-121. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.117

Abstract

PURPOSE
To evaluate the rate of mortality for the elderly patients after treatment of hip fractures and analyze the associated risk factors which might affect their mortality rate.
MATERIALS AND METHODS
About the clinical records on 305 patients who had undergone the treatment in hip fractures, we evaluated the mortality rate of the total number of 248 patients whose age between 70 and 103 who were followed more than 12 months of period between March 1994 and March 2003. The mean age was 81.3 years. The composition of each female and male were 176 and 72 cases respectively. 99 cases were femoral neck fractures, and 149 cases were femoral intertrochanteric fractures. The operation included bipolar hemiarthroplasty and internal fixation using multiple cannulated screws, compression hip screws and Ender nails. We compared and analyzed the relating factors for the mortality rate.
RESULTS
The mean postoperative mortality rate was 14.1% (35 cases). The highest mortality rate showed for the postoperative 3 months which was 57.1% (20 cases), between 4 and 6 months was 25.7% (9 cases), and 17.1% (6 cases) were presented for 7 and 12 months. The postoperative mortality rate within 1 year was affected by underlying diseases, ASA (American society of Anesthesiologists) and cemented bipolar hemiarthroplasty. but, there were no significant difference of the other factors such as the age, gender, osteoporosis and delayed operation.
CONCLUSION
The variable factors which affect the mortality rate of the hip fractures in the elderly patients whose age over 70 were mostly determined by underlying diseases, ASA grade, and cemented bipolar hemiarthroplasty. Further study should be necessary for the factors influencing on the mortality rate.

Citations

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Finite element modeling and simulation of hip joints in elderly women: for development of protective clothing against fracture
Jinhee Park, Yun Ja Nam
International Journal of Clothing Science and Technology.2020; 32(5): 661. CrossRef
Anesthetic considerations for surgical treatment of geriatric hip fracture
Dong Kyu Lee, Seunguk Bang, Sangseok Lee
Anesthesia and Pain Medicine.2019; 14(1): 8. CrossRef
The Influence of Stroke on Postoperative Prognosis of Femoral Intertrochanteric Fractures
Youn Soo Hwang, Kyu Pill Moon, Kyung Taek Kim, Won Seok Park, Joon Yeon Song, Jeong Hoon Chae
Journal of the Korean Orthopaedic Association.2016; 51(4): 273. CrossRef
Analysis of the Risk Factors and Clinical Outcomes of Femoral Intertrochanteric Fractures in Patients over 65 Years Old
Chul Hong Kim, Kyu Yeol Lee, Sung Soo Kim, Myung Jin Lee, Lih Wang, Hyeon Jun Kim, Jung Mo Kang
Hip & Pelvis.2013; 25(2): 127. CrossRef
Postoperative Mortality and the Associated Factors in Elderly Patients with Hip Fracture
You-Sung Suh, Yong-Beom Kim, Hyung-Suk Choi, Hong-Kee Yoon, Gi-Won Seo, Byung-Ill Lee
Journal of the Korean Orthopaedic Association.2012; 47(6): 445. CrossRef
Risk Factors for Cardiovascular Complications Following Hip Surgery
Kuen Tak Suh, Seung Joon Rhee, Jung Sub Lee, Jeung Il Kim
Hip & Pelvis.2012; 24(2): 71. CrossRef
Current Recommendations for Laboratory Testing and Use of Bone Turnover Markers in Management of Osteoporosis
Jehoon Lee, Samuel Vasikaran
Annals of Laboratory Medicine.2012; 32(2): 105. CrossRef
The Daily Life Functions of Elderly Peritrochanteric Fracture Patients after Surgical Treatment
Dae Moo Shim, Tae Kyun Kim, Jong Yun Kim, Duk Hwa Choi, Joung Suk Lee, Seong In Lee
Journal of the Korean Fracture Society.2012; 25(1): 8. CrossRef
One-Year Mortality Rate of Patients over 65 Years Old with a Hip Fracture
Phil Hyun Chung, Suk Kang, Jong Pil Kim, Young Sung Kim, Ho Min Lee, Young Hwa Choi
Hip & Pelvis.2011; 23(2): 137. CrossRef
Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -
Joon Soon Kang, Kyoung Ho Moon, Rhu Seop Kim, Sang Ho Lee, Jong Min Choi
Journal of the Korean Fracture Society.2011; 24(1): 16. CrossRef
Bipolar Hemiarthroplasty for Hip Fractures in Patients Aged over 90 Years - The Factors Influencing the Postoperative Mortality -
Jun-Dong Chang, Je-Hyun Yoo, Sang-Soo Lee, Tae-Young Kim, Kyu-Hak Jung, Yong-Kuk Kim
Hip & Pelvis.2010; 22(4): 283. CrossRef
Determination of an Applicable FRAX Model in Korean Women
Dong-Yun Lee, Seung-Jae Lim, Young-Wan Moon, Yong-Ki Min, DooSeok Choi, Byung-Koo Yoon, Youn-Soo Park
Journal of Korean Medical Science.2010; 25(11): 1657. CrossRef
Postoperative Mortality and the Associated Factors for Senile Hip Fracture Patients
Dong-Soo Kim, Hyun-Chul Shon, Yong-Min Kim, Eui-Sung Choi, Kyoung-Jin Park, Se-Hyuk Im
The Journal of the Korean Orthopaedic Association.2008; 43(4): 488. CrossRef

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Treatment of Intertrochanteric Fracture of the Femur with Ender Nail in the Elderly Patients with High Risk of Anesthesia: Ju yong Shin, Duk Hwan Kho, Dong Ok Kim, Dong Heon Kim; J Korean Fract Soc 2004;17(2):202-207. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.202

Abstract PDF: PURPOSE
To evaluate the usefulness of IM Ender nail in treating femoral intertrochanteric fractures with high risks including cardiovascular disease, pulmonary disease, liver cirrhosis, cerebrovascular disease, metastatic cancer, and skin problem at hip joint region.
MATERIALS AND METHODS
Thirty-five patients of pre-existing diseases and femoral intertrochanteric fractures treated with Ender nailing, January 1990 to November 1997. Under the c-arm guided, closed reduction and internal fixation were performed using Ender nails, We analized operation time, blood loss, bone union, ambulation time and complications RESULTS: Mean operation time was 55 minutes, mean blood loss was 120 ml, mean radiological bone union was 12 weeks and average of partial weight bearing was 6.9 days. Postoperative complications were gastrointestinal discomfort in 3 cases, superficial wound infection in 1 case, knee pain in 7 cases, inguinal pains in 5 cases, distal migration of nails in 3 cases, varus deformity in 2 cases, proximal migration of nail with nonunion in 1 case.
CONCLUSION
The intramedullary ender nail is useful method in treating femoral intertrochanteric fractures in high risk patients of anesthesia and blood loss or skin problem at hip joint region.

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Treatment of Nonunion of the Tibia Fracture: Dong Heon Kim, Kyu Cheol Shin, Hee Cheol Park, Ju Yong Shin; J Korean Soc Fract 1996;9(1):112-118. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.112

Abstract PDF: Nonunion after tibia fracture is a relatively common problem. The cases of nonunion have been known open and comunited fracture, extensive soft tissue injury, interposition of the soft tissue, distarbance of the blood supply and inadequate fixation. A number of methods stimulating union have born described. These include fibular osteotomy followed by weight-bearing in a cast, autogenous boone graft with or without additional stabilization, internal or external fixation with compression, open or closed IM nailing and even electromagetic stimulation. In this paper we carried out retrospective study of the 24 nonunion of the tibia fracture which were treated at the Department of Orthopeadic Surgery, Kon-Kuk University Hospital from March 1990 to March 1995. The results were as follows: 1. Among 24 cases of monunions, 16cases(66.6%) were communited fractures and 18cases(75%) were open fractures. 2. Hypervascular nonunion were 12cases and avascular nonunion were 12cases. Previous methods of treatinent were conservative treatment in 6cases of closed fracture and were treated with Ender nailing, multiple K-wire fixation, Ilizarolr external fixation, monofixator external fixation in 1 Bcases of open fractures. 3. The average duration from injury to dignosis of nonunion was 7 months tweets.(Range 5 months to 24months) 4. Tibial nonunion were treated with plate and screw with bone graft(Bcases), Interlocking IM nail ing(14cases), and nizarov external fixation with bone graft(teases). 5. The average time of union was 23weeks in all patients: 24 weeks in the case of plate and screw with bone graft. 20 weeks in the case of interlocking IM nailing. 28 weeks in the case Ilizarov external fixation with bone graft. 6. The main complications were joint stiffness due to long-term cast irnrnobiliBation in the case of plate and screw with bone graft, LROM of joint contracture and external pin site in the case of Ilizarov external fixation with bone graft, deep infection Icase and knee joint pain teases due to proximal nail protrusion in the case of Interlocking IM nailing.

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The Treatment of Volar Iunate Dislocation and Perilunar Dislocation: Kyu Cheol Shin, Dong Heon Kim, Ju Yong Shin; J Korean Soc Fract 1995;8(4):902-913. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.902

Abstract PDF

The treatment methods of volar lunate dislocation and dorsal perilunar dislocation were introduced variably. We treated 7 cases of volar lunate and dorsal perilunar dislocation by closed reduction and K-wire fixation, open reduction and isolated lunate excision. The 1 case of trans-scaphoid dorsal perilunar dislocation was treated by closed reduction and Herbert screw fixation. The result were as followed: 1. The early diagnosis and early treatment is the most improtant. 2. The closed reduction and percutaneous pinning has advatage of maintenance of reduction and stability of wrist joint. 3. The advantage of Herbert screw fixation is anatomical reduction of the scaphoid fracture but disadvantage is technical difficulty. 4. In open reduction, we must choose the approach that minimiBe the vascular damage to the lunate from the volar side. 5. The isolated lunate excision is not advised.

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Carpal Tunnel Syndrome and Rupture of Flexor Tendon Associated from Neglected Anterior Lunate Dislocation
Young Yool Chung, Young Jae Jang
Journal of the Korean Society for Surgery of the Hand.2015; 20(1): 33. CrossRef
Surgical Treatment of the Perilunate Dislocation and the Lunate Dislocation with Dorsal Approach
Soo-Hong Han, Jin-Myoung Dan, Dong-Hoon Lee, Young-Woong Kim
Journal of the Korean Fracture Society.2011; 24(4): 347. CrossRef
Combined Lunate and Triquetrum Fracture: A Case Report
Joo-Hak Kim, Hyung-Soo Kim, Soo-Tae Chung, Jeong-Hyun Yoo, Seung-Do Cha, Joong-Hyo Lee, Jai-Hyung Park
Journal of the Korean Fracture Society.2008; 21(4): 320. CrossRef

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