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  1. Article ; Online: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom.

    Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

    Journal of orthopaedic trauma

    2020  Volume 34, Issue 9, Page(s) e325–e329

    Abstract: Objectives: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom.: ... ...

    Abstract Objectives: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom.
    Methods: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from "day 0" of the COVID-19 pandemic in the United Kingdom and continued for 30 days. We collected data on time to surgery, Clinical Frailty Scale score, Nottingham Hip Fracture Score, COVID-19 infection status, 30-day mortality, and cause of death. For comparison, we collected retrospective data during the same 30-day period in 2018, 2019, and the previous 6 months (Control groups A, B, and C, respectively).
    Results: Forty-three patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P = 0.022), B (P = 0.003) and C (P = 0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the 7 mortalities recorded, 4 patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P = 0.002, odds ratio 2.4).
    Conclusions: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality.
    Level of evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
    MeSH term(s) Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Female ; Fracture Fixation, Internal ; Hip Fractures/complications ; Hip Fractures/mortality ; Hip Fractures/surgery ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Prospective Studies ; Risk Factors ; SARS-CoV-2 ; Survival Rate ; Time Factors ; United Kingdom
    Keywords covid19
    Language English
    Publishing date 2020-08-17
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 639099-7
    ISSN 1531-2291 ; 0890-5339
    ISSN (online) 1531-2291
    ISSN 0890-5339
    DOI 10.1097/BOT.0000000000001889
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Implant fracture of the TFNA femoral nail.

    Nayar, Sandeep Krishan / Ranjit, Srinath / Adebayo, Oliver / Hassan, Syed Mahmood / Hambidge, John

    Journal of clinical orthopaedics and trauma

    2021  Volume 22, Page(s) 101598

    Abstract: Background: The TFNA (Trochanteric Fixation Nail Advanced) Proximal Femoral Nailing System (DePuy Synthes) is frequently used for intramedullary fixation of proximal femoral fractures. The aim of this study was to evaluate all TFNA implant fractures at ... ...

    Abstract Background: The TFNA (Trochanteric Fixation Nail Advanced) Proximal Femoral Nailing System (DePuy Synthes) is frequently used for intramedullary fixation of proximal femoral fractures. The aim of this study was to evaluate all TFNA implant fractures at a UK trauma unit to ascertain any patient or surgical factors associated with implant failure.
    Methods: A retrospective study was carried out identifying all patients that sustained a TFNA implant fracture over a five-year period. Data was collected on demographic information, ASA, co-morbidities, mechanism of injury, fracture pattern according to the AO/OTA classification, procedure details and time to failure. Radiographs were assessed by two independent reviewers to identify tip-apex distance (TAD), calcar TAD, reduction quality and union status at time of implant failure.
    Results: Six cases were identified, all with implant breakage at the aperture for the proximal screw. All femoral fractures were intertrochanteric reverse obliquity type (OA/OTA 31A3). Two were traumatic fragility fractures and the remainder atraumatic. Mean time from index surgery to revision was 441 days (104-963). Mean TAD was 20.5 mm (15-24) and mean calcar TAD 24 mm (18-32). All six cases displayed radiographic non-union at the time of implant fracture.
    Conclusion: Pathological fractures resulting in reverse obliquity type fracture patterns and subsequent non-union appear to be contributory factors to TFNA breakage at the proximal screw aperture. This may be further exacerbated by alterations to the nail design from previous generations. In these patients, close follow up with clinical and radiographic surveillance should be employed. Further biomechanical and clinical studies are required to compare this finding against other nail designs.
    Language English
    Publishing date 2021-09-20
    Publishing country India
    Document type Journal Article
    ZDB-ID 2596956-0
    ISSN 2213-3445 ; 0976-5662
    ISSN (online) 2213-3445
    ISSN 0976-5662
    DOI 10.1016/j.jcot.2021.101598
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom

    Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

    J Orthop Trauma

    Abstract: OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom. ... ...

    Abstract OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first 30 days of the pandemic in the United Kingdom. METHODS: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from "day 0" of the COVID-19 pandemic in the United Kingdom and continued for 30 days. We collected data on time to surgery, Clinical Frailty Scale score, Nottingham Hip Fracture Score, COVID-19 infection status, 30-day mortality, and cause of death. For comparison, we collected retrospective data during the same 30-day period in 2018, 2019, and the previous 6 months (Control groups A, B, and C, respectively). RESULTS: Forty-three patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P = 0.022), B (P = 0.003) and C (P = 0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the 7 mortalities recorded, 4 patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P = 0.002, odds ratio 2.4). CONCLUSIONS: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #732070
    Database COVID19

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  4. Article: 30-day Mortality Rate of Patients with Hip Fractures during the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom

    Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

    J. orthop. trauma

    Abstract: OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first thirty days of the pandemic in the UK. METHODS: A ... ...

    Abstract OBJECTIVES: During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. Our study aims to investigate the 30-day mortality rate of hip fracture patients during the first thirty days of the pandemic in the UK. METHODS: A single-center, observational, prospective study of patients presenting with hip fractures. Data collection started from 'day zero' of the COVID-19 pandemic in the UK and continued for thirty days. We collected data on time-to-surgery, Clinical Frailty Scale (CFS) score, Nottingham Hip Fracture Score (NHFS), COVID-19 infection status, 30-day mortality and cause of death. For comparison, we collected retrospective data during the same thirty-day period in 2018, 2019 and the previous six months (Control groups A, B and C, respectively). RESULTS: 43 patients were included in the study. There was no difference in age or gender between the Study and Control groups. The 30-day mortality rate of the Study group was 16.3%, which was higher than Control groups A (P=0.022), B (P=0.003) and C (P=0.001). The prevalence of COVID-19 infection in our Study group was 26%. Of the seven mortalities recorded, four patients tested positive for COVID-19 infection. In our Study group, COVID-19 infection correlated significantly with 30-day mortality (P=0.002, odds ratio 2.4). CONCLUSIONS: Our study demonstrated a significant increase in 30-day mortality amongst hip fracture patients during the first thirty days of the COVID-19 pandemic in the UK. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #641504
    Database COVID19

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  5. Article ; Online: Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic

    Thakrar, Amit / Chui, Karen / Kapoor, Akhil / Hambidge, John

    Journal of Orthopaedic Trauma

    A Single Centre Prospective Study in the United Kingdom

    2020  Volume 34, Issue 9, Page(s) e325–e329

    Keywords Surgery ; Orthopedics and Sports Medicine ; General Medicine ; covid19
    Language English
    Publisher Ovid Technologies (Wolters Kluwer Health)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 639099-7
    ISSN 0890-5339
    ISSN 0890-5339
    DOI 10.1097/bot.0000000000001889
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2234: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: A simple measure to improve the rates of thromboprophylaxis prescription post surgical fixation of neck of femur fractures in a district general hospital.

    Sinha, Pranab / Najefi, Ali-Asgar / Hambidge, John

    BMJ quality improvement reports

    2014  Volume 3, Issue 1

    Abstract: Neck of femur (NOF) fractures are a major public health concern because of the ageing population and higher incidence of fragility fractures. NOF fractures are associated with high mortality and morbidity rates, and there is a high risk of venous ... ...

    Abstract Neck of femur (NOF) fractures are a major public health concern because of the ageing population and higher incidence of fragility fractures. NOF fractures are associated with high mortality and morbidity rates, and there is a high risk of venous thromboembolism (VTE) after hip fractures (Ref 1). Therefore thromboprophylaxis is vital. Current NICE guidelines advocate 28 - 35 days of thromboprophylaxis after NOF fractures (Ref 1, 2). It came to our attention that patients post NOF fixation were getting variable prescriptions in regards to their thromboprophylaxis. Therefore a retrospective study on prescription of thromboprophylaxis was conducted from October 2012 to February 2013 within the trauma and orthopaedics department at Queens Hospital, Romford. Data was collected on all NOF fractures from electronic discharge summaries. Basic descriptive statistics were used to analysis the data. There were 110 cases of NOF fractures during this period. 100 patients were included since two were discounted as they were already on long term anticoagulants and eight patients died in hospital. No thromboprophylaxis was prescribed for 15 patients (15%). Three patients (3%) were prescribed less than 28 days (mean 14 days, range (14 - 14 days)). 69 patients (69%) received 28 - 35 days of thromprophylaxis, whilst five patients (5%) received more than 35 days (mean 42 days, range 40 - 42 days). Formal departmental teaching and presentation of the findings was given after the initial study and a small label with the message, 'POST NOF #: 28-35 days Enoxaparin', was attached to the back of all the junior doctor work phones. After the intervention, data was collected from the period of 7th of January to 7th of February 2013. The second study showed that 50 patients were admitted with NOF fractures in this time period. Four patients died in hospital and three patients were discounted as they were on Warfarin. Two patients were not prescribed thromboprophylaxis (5%). 34 (79%) patients received 28 - 35 days, whereas seven patients (16%) received 42 days of thromboprophylaxis. The older patients with multiple co-morbidities and reduced mobility are at high risk of developing thromboembolism post NOF fixation. Our initial study identified inadequate prescription of thromboprophylaxis post NOF fractures. After introduction of simple measures such as the reminder label attached to phones, our repeat study found that there was improvement in prescription rates. Our study highlights that simple measures can increase awareness and improve patient safety.
    Language English
    Publishing date 2014-05-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2677829-4
    ISSN 2050-1315
    ISSN 2050-1315
    DOI 10.1136/bmjquality.u202991.w1956
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  7. Article ; Online: Polyaxial versus uniaxial volar locking plate for distal radial fractures.

    Al-Mouazzen, Louay / Chou, Daud Tai Shan / Kyriakopoulos, Georgios / Hambidge, John

    Journal of orthopaedic surgery (Hong Kong)

    2014  Volume 22, Issue 1, Page(s) 9–12

    Abstract: Purpose: To compare the penetration of the distal screws in relation to the thickness of the distal metaphysis in the polyaxial versus uniaxial volar locking plates.: Methods: Records of 78 patients aged 16 to 79 years who underwent open reduction ... ...

    Abstract Purpose: To compare the penetration of the distal screws in relation to the thickness of the distal metaphysis in the polyaxial versus uniaxial volar locking plates.
    Methods: Records of 78 patients aged 16 to 79 years who underwent open reduction and internal fixation for distal radial fractures (n=81) were reviewed. All fracture subtypes were included. 20 men and 22 women aged 18 to 79 (mean, 50) years were treated with the uniaxial locking plate, whereas 15 men and 21 women aged 16 to 79 (mean, 51) years were treated with the polyaxial locking plate. The choice of plate was determined by the operating surgeon based on familiarity and perceived advantages of the 2 plates. Penetration of the distal locking screws in relation to the volar-dorsal thickness of the distal radial metaphysis was measured, and the percentage of subchondral bone unsupported by the screws calculated.
    Results: The mean percentage of unsupported subchondral bone was significantly lower in the polyaxial than uniaxial volar locking plate group (12% vs. 23%, p<0.001). No patient had screw over-penetration.
    Conclusion: The polyaxial volar locking plate system enabled deeper insertion of distal screws into the subchondral bone, and thus providing better buttress for the fracture fragments.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bone Plates ; Bone Screws ; Female ; Follow-Up Studies ; Fracture Fixation, Internal/instrumentation ; Fracture Healing ; Humans ; Male ; Middle Aged ; Palmar Plate/surgery ; Prosthesis Design ; Radiography ; Radius Fractures/diagnostic imaging ; Radius Fractures/surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2014-04
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 1493368-8
    ISSN 2309-4990 ; 1022-5536
    ISSN (online) 2309-4990
    ISSN 1022-5536
    DOI 10.1177/230949901402200105
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5104: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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