Background: We retrospectively analyzed 112 intertrochanteric femur fracture patients and 136 femoral neck fracture patients to determine mortality rates and factors affecting mortality. Internal fixation is the standard treatment method for intertrochanteric femur fracture patients in our institute, and arthroplasty, as a treatment choice, shows an increase in mortality rates. We wanted to convey if there was any decrease in mortality rate of intertrochanteric femur fracture patients when compared with femoral neck fracture patients who were almost always treated with arthroplasty. Methods: Patients' age at admission, trauma date, delay until surgery, comorbidities, operation durations, anesthesia, and treatment types were evaluated by patients' folders. All preoperative and postoperative radiographs checked over for treatment type. Patients' recent health and activity status were determined by telephone interview. Results: There were no significant differences in mortality rates between patients of two fracture types. Treatment type, anesthesia type, and sex were significant predictors in univariate analyses. In multivariate analyses, only age and delay in surgery identified as predictors of mortality, age was the most significant. Although intertrochanteric femur fracture patients were significantly older than femoral neck fracture patients, the estimated mean survival time was higher for intertrochanteric femur fracture patients (57.9 months) than for femoral neck fracture patients (48.8 months). Conclusion: We think that, in addition to the shorter delay in surgery, internal fixation choice led to decrease the mortality rate of intertrochanteric femur fracture patients. In conclusion, to decrease the mortality rate after hip fracture, since age and sex cannot be changed, needless delays in surgery should be avoided. Also, we recommend internal fixation and regional anesthesia to decrease the mortality rate.
2 August 2014 in European Journal of Orthopaedic Surgery & Traumatology
INTRODUCTION: Several complications can be observed after Achilles tendon repairs. In this study we aimed to report granuloma formation secondary to Achilles tendon repair with Ethibond (Ethicon INC, Somerville, New Jersey) suture. PRESENTATION OF CASE: A 31 year-old man operated for Achilles tendon rupture. The Ethibond suture was used for primary repair. The patient attended to polyclinic with the complaints of swelling and discharge around the operation site four months after operation. A mass around distal portion of the Achilles tendon was detected. The granulomatous tissue was excised. Inside the mass Ethibond suture was detected. On histopathologic examination, typical findings of the foreign body reaction were observed. No microorganism was cultivated in the tissue culture. The patient has no complaint on the twelfth month control after surgery. DISCUSSION: The results of primary repair of Achilles tendon are good but several complications were reported. In tendon repairs generally nonabsorbable sutures are used. The Ethibond is nonabsorbable, braided suture. In the literature, granuloma formations secondary to the suture materials such as polygylactine and braided polyethylen-polyester after Achilles tendon repair were reported but granuloma secondary to the Ethibond is very rare. CONCLUSION: Although Ethibond suture is a strong and safe material for Achilles tendon repairs it may cause soft tissue problems such as granuloma. Highlights:
11 July 2016 in Archives of orthopaedic and trauma surgery