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Your search keyword '"Verhofstad, M.H.J."' showing total 4 results
Start Over Author "Verhofstad, M.H.J." Topic fracture fixation
4 results on '"Verhofstad, M.H.J."'

1. Cumulative incidence and treatment of non-simultaneous bilateral femoral neck fractures in a cohort of one thousand two hundred and fifty patients

Author

Burgers, P.T., Zielinski, S.M., Mailuhu, A.K., Heetveld, M.J., Verhofstad, M.H.J., Roukema, G.R., Patka, P., Poolman, R.W., Lieshout, E.M. van, Biert, J., Surgery, and Emergency Medicine

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Arthroplasty, Replacement, Hip, Femoral Neck Fractures, Fracture Fixation, Internal, Risk Factors, Fracture fixation, medicine, Humans, Orthopedics and Sports Medicine, Cumulative incidence, Aged, Netherlands, Retrospective Studies, Aged, 80 and over, Hip fracture, business.industry, Incidence, Retrospective cohort study, medicine.disease, Arthroplasty, Surgery, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Cohort, Orthopedic surgery, Female, business
Abstract

Item does not contain fulltext PURPOSE: In the Netherlands, over 20,000 patients sustain a hip fracture yearly. A first hip fracture is a risk factor for a second, contralateral fracture. Data on the similarity of the treatment of bilateral femoral neck fractures is only scarcely available. The objectives of this study were to determine the cumulative incidence of non-simultaneous bilateral femoral neck fractures and to describe the patient characteristics and treatment characteristics of these patients. METHODS: A database of 1,250 consecutive patients with a femoral neck fracture was available. Patients with a previous contralateral femoral neck fractures were identified by reviewing radiographs and patient files. Patient characteristics, previous fractures, hip fracture type and details on treatment were collected from the patient files. RESULTS: One hundred nine patients (9%, 95% confidence interval 7-10%) had sustained a non-simultaneous bilateral femoral neck fracture. The median age at the first fracture was 81 years; the median interval between the fractures was 25 months. Overall, 73% was treated similarly for both fractures in terms of non-operative treatment, internal fixation or arthroplasty. In patients with identical Garden classification (30%), treatment similarity was 88%. CONCLUSIONS: The cumulative incidence of non-simultaneous bilateral femoral neck fractures was 9%. Most patients with identical fracture types were treated similarly. The relatively high risk of sustaining a second femoral neck fracture supports the importance of secondary prevention, especially in patients with a prior wrist or vertebral fracture. 01 november 2014

Published
2014

2. Adherence to a femoral neck fracture treatment guideline

Author

Zielinski, S.M., Meeuwis, M.A., Heetveld, M.J., Verhofstad, M.H.J., Roukema, G.R., Patka, P., Lieshout, E.M. van, Biert, J., Kampen, A. van, Surgery, and Emergency Medicine

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Arthroplasty, Replacement, Hip, Femoral Neck Fractures, Fracture Fixation, Internal, Young Adult, Fracture fixation, Medicine, Humans, Orthopedics and Sports Medicine, Orthopedic Procedures, Practice Patterns, Physicians', Child, Femoral neck, Aged, Netherlands, Retrospective Studies, Human Movement & Fatigue [NCEBP 10], Aged, 80 and over, Hip fracture, Original Paper, business.industry, Age Factors, Infant, Newborn, Infant, Retrospective cohort study, Guideline, Middle Aged, medicine.disease, Arthroplasty, medicine.anatomical_structure, Child, Preschool, Orthopedic surgery, Practice Guidelines as Topic, Physical therapy, Surgery, Female, Evaluation of complex medical interventions Tissue engineering and pathology [NCEBP 2], Guideline Adherence, business
Abstract

Item does not contain fulltext PURPOSE: In 2007 the Dutch Surgical Society published a clinical practice guideline for the treatment of hip fracture patients, based on the best available international evidence at that time. We investigated to what extent treatment of femoral neck fracture patients in the Netherlands corresponded with these guidelines, and determined differences in patient characteristics between the treatment groups. METHODS: All femoral neck fracture patients treated in 14 hospitals between February 2008 and August 2009 were included. Patient characteristics, X-rays, and treatment data were collected retrospectively. RESULTS: From a total of 1,250 patients 59% had been treated with arthroplasty, 39% with internal fixation, and 2% with a non-operative treatment. While 74% of the treatment choices complied with the guideline, 12% did not. In 14% adherence could not be determined from the available data. Arthroplasty was preferred over internal fixation in elderly patients with severe comorbidity, pre-fracture osteoporosis and a displaced fracture, who were ambulatory with aids pre-fracture (odds ratio, OR 2.2-58.1). Sliding hip screws were preferred over cancellous screws in displaced fractures (OR 1.9). CONCLUSIONS: Overall guideline adherence was good. Most deviations concerned treatment of elderly patients with a displaced fracture and implant use in internal fixation. Additional data on these issues, preferably at a higher scientific level of evidence, is needed in order to improve the guideline and to reinforce a more uniform treatment of these patients.

Published
2013

3. Construct failure after open reduction and plate fixation of displaced midshaft clavicular fractures.

Author

Meeuwis, M.A., Pull ter Gunne, A.F., Verhofstad, M.H.J., and van der Heijden, F.H.W.M.

Subjects
*CLAVICLE injury treatment, *FRACTURE fixation, *BONE screws, *COMPRESSION therapy, *UNIVARIATE analysis, *CLAVICLE injuries, *CLAVICLE, *BONE fractures, *LONGITUDINAL method, *ORTHOPEDIC implants, *COMPLICATIONS of prosthesis, *REOPERATION, *SURGICAL complications, *RETROSPECTIVE studies
Abstract

Introduction: Worldwide, implants mostly used for fixation of displaced midshaft clavicular fractures (DMCF) are the easily to bend reconstruction plate and the stiffer small fragment locking compression plate. Construct failure rates after plate fixation of DMCF are reported around 5 percent. Possible risk factors for construct failure are implant type and fracture type. However, little is known about the influence of fracture fixation method on construct failure. The aim of this study was to assess construct failure in plate fixation of DMCF and to identify possible risk factors.Methods: All consecutive patients treated in a level 1 trauma centre with open reduction and fixation of DMCF using a 3.5-mm reconstruction plate or 3.5-mm small fragment locking compression plate between 2007 and 2015 were evaluated. Potential risk factors for construct failure were analysed using univariate analysis.Results: Two hundred and fifty-nine patients were analysed. Fifty DMCF (19%) were fixated with a reconstruction plate and 209 (81%) with a small fragment locking compression plate. Construct failure was seen in 18 patients (6.9%), including 5 broken plates and 13 with screw loosening. Eight percent of all reconstruction plates broke in contrast to 0.5 percent of all small fragment locking compression plates (p=0.001). All broken implants were used as a bridging plate. Loosening of screws was seen in older patients and when the plate was fixated with less than three bicortical screws on one side of the fracture (p=0.002).Conclusions: Overall construct failure after open reduction and plate fixation of DMCF occurred in 6.9 percent. Risk factors for plate breakage were the use of a reconstruction plate and a bridging method for fracture fixation. Risk factors for screw loosening were an increasing patient age and plate fixation with less than three bicortical screws on one side of the fracture.Recommendations: Based on the results of this study our recommendation is to use a small fragment locking compression plate for open reduction and internal fixation of DMCF. The surgeon should always strive to fixate the plate on both sides of the fracture with at least three bicortical screws. [ABSTRACT FROM AUTHOR]

Published
2017
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4. Use of antibiotic coated intramedullary nails in open tibia fractures: A European medical resource use and cost-effectiveness analysis.

Author

Franz, D., Raschke, M., Giannoudis, P.V., Leliveld, M., Metsemakers, W.J., Verhofstad, M.H.J., Craig, J.A., Shore, J., Smith, A., Muehlendyck, C., Kerstan, M., and Fuchs, T.

Subjects
*RESEARCH, *ORTHOPEDIC implants, *META-analysis, *RESEARCH methodology, *MEDICAL cooperation, *EVALUATION research, *TREATMENT effectiveness, *COMPARATIVE studies, *COMPOUND fractures, *FRACTURE fixation, *COST effectiveness, *TIBIAL fractures, *TIBIA, *ANTIBIOTICS
Abstract

Purpose: In patients with open tibial fractures, bone and wound infections are associated with an increased hospital length of stay and higher costs. The infection risk increases with the use of implants. Innovations to reduce this risk include antibiotic-coated implants. This study models whether the use of a gentamicin-coated intramedullary tibial nail is cost-effective for trauma centers managing patients with a high risk of infection.Efficacy: Absolute infection risk and relative risk reduction, by fracture grade, for antibiotic-coated nails compared to standard nails for patients with open tibial fractures were estimated based on the results of a meta-analysis, which assessed the additional benefit of locally-administered prophylactic antibiotics in open tibia fractures treated with implants. The observed efficacy of antibiotic-coated nails in reducing infections was applied in an economic model.Methods: The model compared infection rates, inpatient days, theatre usage and costs in high risk patients, with a Gustilo-Anderson (GA) grade III open fracture, for two patient cohorts from a trauma center perspective, with a 1-year time horizon. In one cohort all GAIII patients received a gentamicin-coated nail whilst GAI and GAII patients received a standard nail. All patients in the comparator cohort received a standard nail. Four European trauma centers provided patient-level data (n=193) on inpatient days, procedures and related costs for patients with and without infections.Results: Using the gentamicin-coated nail in patients at high risk of infection (GAIII) was associated with 75% lower rate of infection and cost savings (€477 - €3.263) for all included centers; the higher cost of the implant was offset by savings from fewer infections, inpatient days (-26%) and re-operations (-10%). This result was confirmed by extensive sensitivity analyses.Conclusions: Analyses demonstrated that infection rates and total costs for in-hospital treatment could be potentially reduced by 75% and up to 15% respectively, by using a gentamicin-coated nail in patients at high risk of infection. Fewer infections, reduced inpatient days and re-operations may be potentially associated with use of antibiotic-coated implants. Results are sensitive to the underlying infection risk, with greatest efficacy and cost-savings when the coated implant is used in high risk patients. [ABSTRACT FROM AUTHOR]

Published
2021
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