Instructional Course Lecture   |    
Geriatric Trauma: The Role of Immediate Arthroplasty
Andrew H. Schmidt, MD1; Jonathan P. Braman, MD2; Paul J. Duwelius, MD3; Michael D. McKee, MD, FRCS(C)4
1 Department of Orthopedic Surgery, Hennepin County Medical Center, 701 Park Avenue, Mailcode G2, Minneapolis, MN 55415. E-mail address: schmi115@umn.edu
2 Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, #R200, Minneapolis, MN 55454. E-mail address: brama011@umn.edu
3 Orthopedic and Fracture Specialists, 11782 SW Barnes Road, Suite 300, Portland, OR 97225. E-mail address: pduwelius@gmail.com
4 Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, St. Michael’s Hospital, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada. E-mail address: mckeem@smh.ca
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An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy’s Annual Meeting, will be available in March 2014 in Instructional Course Lectures, Volume 63. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, one or more of the authors has had another relationship, or has engaged in another activity, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Dec 18;95(24):2230-2239
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Periarticular fractures in the elderly are difficult to stabilize, and nonoperative treatment is not well tolerated. Surgery is usually indicated, but standard techniques of internal fixation often fail in this age group because of osteopenic bone and fracture comminution. These factors often prevent sufficient fixation to allow early weight-bearing, which is of critical importance in the geriatric patient.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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    Akbar Hussaini, MD
    Posted on December 23, 2013
    Timing of THA after femoral neck fracture; non-displaced femoral neck fractures; Trauma vs Arthroplasty primary Surgeon
    Seton Highland Lakes, Burnet,TX, USA

    Could the authors comment on:

    1. Possible bias in existing literature for ORIF in femoral neck fracture treatment, given that many studies are published by trauma surgeons/centers, and not arthroplasty surgeons in treatment of femoral neck fracture.
    2. The role of arthroplasty in non-displaced femoral neck fracture in octogenarians.
    3. Timing of arthroplasty (typically stated as within 48hrs from admission in most studies) for these patients, is there a detriment to operating later (2-4 days)?

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