[AC] Orthopaedics: Lower Limb ||

Question 1

In the year 2000, what was the incidence of osteoporotic fractures globally? How many were reported as hip fractures?

Answer 1

Approx 9 million osteoporotic fractures world-wide; 1.6 million were reported at the hip

Question 2

Hip fracture patients with more comorbidities have a higher risk of postoperative complications and mortality. What are some medical comorbidities?

Answer 2

Cardiac -> congestive heart failure, arrhythmia, ischemic heart disease, valvular pathologies
Cognitive Impairment -> confusion, dementia (can impact on patient’s ability to rehabilitate from hip fracture)

Question 3

The FRAXX tool was developed by WHO to evaluate fracture risk of patients. What does it provide?

Answer 3

10-year probability of a fracture and 10-year probability of a major osteoporotic fracture

Question 4

Blood clots or DVT can occur in up to 30% of people undergoing joint replacement. Can be deadly due to possible pulmonary embolism.
How is the risk reduced?

Answer 4

Risk is reduced by early mobilisation, use of elastic stockings and aspirin for 6 weeks

Question 5

What are some identified risk factors that Pryor & Prasad state patients risk for PPC increase by 8 times?

Answer 5

• > Duration of anaesthesia more than 180 minutes
• > Type of surgery performed (upper abdominal)
• > Presence of preoperative respiratory problems (i.e. COPD)
• > Current smoking (within last 8 weeks)
• > Reduced level of preoperative activity (measured using questionnaires etc)

Question 6

There is ____________ evidence to support the use of strength and balance training in older adults identified to be at risk of falls
(acute management of hip fracture)

Answer 6

High quality

Question 7

There is ___________ to support the use of exercise in the acute phase of recovery following a hip fracture

Answer 7

Moderate evidence