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Embden, Daphne van (2016)

Facts and fiction in hip fracture treatment

Doctoral Thesis
As the number of hip fracture patients has increased dramatically over the years, the need for high quality, multidisciplinary and patient centred fracture treatment continues to grow. The first aim of this thesis is to provide better understanding of fracture patterns and classification in hip fractures. Secondly, we investigated what fracture, patient or surgeons' characteristics may lead to improvement of hip fracture care? In Chapters 2 to 6 increased insight in the fracture anatomy was intended and the reliability of the most frequently used classifications for proximal femur fractures were studied. Rotational instability appears to play a significant role in fixation failure. In Chapter 7 the amount of rotational instability in hip fractures, related to type of fracture and modern implants was studied with the use of radiostereometric analysis (RSA). Chapter 8 presents the results of a retrospective cohort study concerning the pre- and post-operative radiographic fracture...Show moreAs the number of hip fracture patients has increased dramatically over the years, the need for high quality, multidisciplinary and patient centred fracture treatment continues to grow. The first aim of this thesis is to provide better understanding of fracture patterns and classification in hip fractures. Secondly, we investigated what fracture, patient or surgeons' characteristics may lead to improvement of hip fracture care? In Chapters 2 to 6 increased insight in the fracture anatomy was intended and the reliability of the most frequently used classifications for proximal femur fractures were studied. Rotational instability appears to play a significant role in fixation failure. In Chapter 7 the amount of rotational instability in hip fractures, related to type of fracture and modern implants was studied with the use of radiostereometric analysis (RSA). Chapter 8 presents the results of a retrospective cohort study concerning the pre- and post-operative radiographic fracture characteristics in relation to patient age and the occurrence of reoperation. The surgeons' intra-operative estimations of the femoral anteversion angle during placement of a hemi-arthroplasty for femoral neck fractures was studied in Chapter 9 and in Chapter 10 a systematic review regarding the treatment dilemmas in non-displaced femoral neck fracture is described.Show less
Radiostereometric analysis
Fracture complications
Fracture classifications
Hip fracture treatment
All authors
Embden, Daphne van
Supervisor
Schipper, I.B.
Co-supervisor
Meylaerts, S.A.G.; Rhemrev, S.J.
Qualification
Doctor (dr.)
Awarding Institution
Department of Trauma Surgery, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Date
2016-02-17
ISBN (print)
9789461697868

Funding

Sponsorship
Grants: Part of thesis was funded by a grant of the Anna Fonds|NOREF. Printing of this thesis has been financially supported by: Nederlandse Vereniging voor Traumachirurgie, Raad van Bestuur Medisch Centrum Haaglanden-Bronovo, Stiching Extra-Curriculaire Activiteiten Haagse Chirurgen, Traumacentrum West, ChipSoft