Abstract：
BACKGROUND:Proximal femoral fractures are common in the elderly. The best care depends on expeditious presentation, medical stabilization, and treatment of the condition. QUESTIONS/PURPOSES:We investigated the risk of increased mortality in residents of rural communities secondary to inaccessible facilities and treatment delays. PATIENTS AND METHODS:We used Medicare Provider Analysis and Review Part A data to identify 338,092 patients with hip fractures. Each patient was categorized as residing in urban, large rural, or small rural areas. We compared the distance traveled, mortality rates, time from admission to surgery, and length of stay for patients residing in each location. RESULTS:Patients in rural areas traveled substantially farther to reach their treating facility than did urban patients: mean, 34.4 miles for small rural, 14.5 miles for large rural, and 9.3 miles for urban. The adjusted odds ratios for mortality were similar but slightly better for urban patients for in-hospital mortality (small rural odds ratio, 1.05; large rural odds ratio, 1.13). Rural patients had a favorable adjusted odds ratio for 1-year mortality when compared with urban patients (small rural odds ratio, 0.93; large rural odds ratio, 0.96). Rural patients experienced no greater delay in time to surgery or longer hospital length of stay. CONCLUSIONS:Although patients living in rural areas traveled a greater distance than those living in urban centers, we found no increase in time to surgery, hospital length of stay, or mortality. LEVEL OF EVIDENCE:Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Miller BJ,Cai X,Cram Pdoi
10.1007/s11999-011-2140-3subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1763-70issue
6eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：:Three typical cases demonstrate the achievement of precision in the reconstruction of ununited fractures of the tibia by preliminary planning with the aid of tracings on roentgenograms, templates, and goniometer measurements. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-09-01 00:00:00
abstract：:Defects from curettage for giant cell tumors of bone frequently have been reconstructed with bone cement with or without reinforcement pins. The biomechanical basis for the addition of reinforcement pins was examined using a model of a contained defect in the proximal tibia. Fifty-four cadaveric proximal tibia in matc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200402000-00038
更新日期：2004-02-01 00:00:00
abstract：:Between 1974 and 1984 the Zickel supracondylar nail system was used to fix 82 femora. Sixty-nine femora had supracondylar fractures and 13 supracondylar osteotomies. A high rate of union (98%) was achieved in the fracture group, which included a variety of fracture types, but five supracondylar osteotomies failed to u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Orthopedic management of the various complications resulting from musculo-skeletal bleeds in the hemophiliac, has now become standard and routine. However, the orthopedist should never minimize the threat of iatrogenic disease resulting from his surgery, or from the hemostatic control necessary for all operations. Ope...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:Seventy-five symptomatic dysplastic hip joints (63 patients) were treated with the Bernese periacetabular osteotomy during a period of 44 months. The mean patients' age was 29 years (range, 13-56 years) and the female:male ratio was 3.4:1. Group III dysplasia according to Severin was seen in 50% and Group IV dysplasia...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-06-01 00:00:00
abstract：BACKGROUND:The most important objective of clinical classifications of slipped capital femoral epiphysis (SCFE) is to identify hips associated with a high risk of avascular necrosis (AVN)--so-called unstable or acute slips; however, closed surgery makes confirmation of physeal stability difficult. Performing the capita...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2339-y
更新日期：2012-08-01 00:00:00
abstract：:A cementless porous-coated femoral prosthesis with a long stem was implanted in seven patients who had untreated comminuted unstable intertrochanteric fractures of the femur associated with a posterior dislocation of the femoral head. The average age of the patients was 35 years (range, 25-52 years). The length of fol...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:The prevalence of hip osteoarthritis and rheumatoid arthritis has been found to be lower in Chinese, Japanese, and other Asian populations than in whites. The low prevalence of osteoarthritis hip in the Chinese and Japanese populations cannot be explained by the rarity of hip dysplasia, which is as prevalent in those ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199602000-00011
更新日期：1996-02-01 00:00:00
abstract：:Isolated human chondrocytes derived from healthy and osteoarthritic (OA) cartilage were cultured in high density in a newly designed microculture system. The severity of OA was graded according to a modified histopathologic score originally described by Mankin et al. Chondrocytes from adult patients with OA showed 35S...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
abstract：:Rupture of the Achilles tendon is being reported more frequently. Results published in the literature in the past 25 years were reviewed to determine the overall outcome comparing surgical with nonsurgical treatment and to identify areas needing further study. The rerupture rate for surgically treated patients was 12/...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
abstract：UNLABELLED:Fractures of the femur after a knee or hip arthroplasty historically have been plagued with high complication rates. The Less Invasive Stabilization System (LISS) has theoretical advantages of improved biomechanics and limited insult to the bone's vascular supply. We theorized that the LISS would have a lowe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000223987.59702.17
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:The innate immune system can recall previous immunologic challenges and thus respond more effectively to subsequent unrelated challenges, a phenomenon called trained immunity. Training the innate immune system before surgery might be a potential option to prevent bone and joint infection. QUESTIONS/PURPOSES...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001461
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:So-called "hazardous attitudes" (macho, impulsive, antiauthority, resignation, invulnerable, and confident) were identified by the Federal Aviation Administration and the Canadian Air Transport Administration as contributing to road traffic incidents among college-aged drivers and felt to be useful for the p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3966-2
更新日期：2015-05-01 00:00:00
abstract：:The etiology of aseptic loosening of prosthetic joint replacement components is unclear. Implant materials have been considered biologically inert, but recently studies indicate that inflammatory reactions directed against the implanted materials may contribute to aseptic loosening. Data suggesting a progression from ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199605000-00008
更新日期：1996-05-01 00:00:00
abstract：:Scoliosis in Marfan's syndrome may be painful, but severe spondylolisthesis with a cauda equina tension syndrome as the cause of pain has only recently been recognized. Scoliosis may be associated with spondylolisthesis. The scoliosis may be sciatic or structural. These may be true structural curves or secondary to th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-08-01 00:00:00
abstract：:Metastases involving the pelvis and lower extremities are common among the large population of cancer patients presently treated by hormonal or chemotherapy. The use of methylmethacrylate as an adjunct to conventional fracture fixation has improved markedly the results of pathological fracture management. Intertrochan...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:The Short Form 36, The Toronto Extremity Salvage Score, and the 1987 and 1993 Musculoskeletal Tumor Society Rating Scales were compared as measures of functional status for patients with lower extremity sarcoma. The study included 97 patients with lower extremity sarcoma and evaluated each measure on the following mea...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Modern hip implants typically feature modular heads, which allow for easy exchange and removal from the femoral stem at the time of revision. However, owing to fretting, corrosion, or cold welding, the modular head may be difficult or impossible to separate from the underlying trunnion, especially if the imp...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1007/s11999-016-4774-7
更新日期：2016-09-01 00:00:00
abstract：:Two hundred seventy-nine patients undergoing primary unilateral total knee replacement and 280 patients undergoing primary bilateral total knee replacements were reviewed retrospectively. Patients' height, weight, hemoglobin level before donation, hemoglobin level before surgery, autologous donation, number and type o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199812000-00008
更新日期：1998-12-01 00:00:00
abstract：:Pseudothrombophlebitis syndrome is the occurrence of calf pain and swelling caused by extrinsic compression of the popliteal vessels by an enlarging Baker's cyst or by calf inflammation that occurs as the result of a ruptured Baker's cyst. Few cases of pseudothrombophlebitis syndrome have been reported in patients les...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-11-01 00:00:00
abstract：:Bone morphogenetic proteins have been proposed as candidate genes for fibrodysplasia ossificans progressiva. Bone morphogenetic protein 4 is overexpressed in cells derived from these patients. The bone morphogenetic protein 4 genes from a family showing autosomal dominant inheritance of fibrodysplasia ossificans progr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:Seven patients who had low supracondylar fractures above total knee arthroplasties were treated using the intramedullary supracondylar rod. Six of the seven patients were steroid-dependent, long-standing severe polyarticular rheumatoid arthritics with marked osteopenia. The intramedullary supracondylar rod provided st...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：:Chondrocytes from adult and immature articular cartilage were separated on the basis of size by rate-zonal centrifugation in a Ficoll density gradient. Lysozomal enzyme activity (acid phosphatase and beta-glucuronidase) was determined in gradient fractions containing chondrocytes of different sizes. Acid phosphatase a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-04-01 00:00:00
abstract：:Recombinant human bone morphogenetic protein-2 is an osteoinductive protein that plays a pivotal role in bone growth and regeneration. Several hundred studies were conducted in the past 7 years in numerous animal models to establish unequivocally the efficacy, safety, mechanism of action, pharmacokinetics, and surgica...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200202000-00011
更新日期：2002-02-01 00:00:00
abstract：:Detailed, long-term studies of cemented total hip arthroplasties clearly show that failure of fixation of the acetabular component is a major problem, with a rising incidence and an unusual complexity. By finite element analysis the stress distribution in the human acetabulum before and after total hip arthroplasty wa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-03-01 00:00:00
abstract：:A solitary fibrous tumor is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that solitary fibrous tumors also affect extrathoracic regions. The current study presents a literature review with four additional patients with solitary fibrous tumor arising ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000065839.77325.b4
更新日期：2003-06-01 00:00:00
abstract：:It is now well established that the meniscus performs a number of roles that are important to the efficient performance of the knee joint. Of particular importance is the recognition of its load-bearing function and its stabilization of the joint during flexion-extension. The compression of the wedge-shaped meniscus d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-11-01 00:00:00
abstract：:Sixteen porous polysulfone-coated canine femoral stems were inserted into 14 dogs. Coatings were approximately 40% porous, with an average pore size of 125 or 250 microns. Bone was formed within at least about 30% of the surface pores of the implants. The tissue ingrowths filling the pores included marrow and fibrous ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：:The right hips of 69 five-day-old rabbits were dislocated surgically and left to develop in the dislocated position to determine the nature and timing of changes in the hip. Using the left hips as controls, 15 survivors were killed and studied macroscopically and microscopically at two months of age and 14 at four mon...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-11-01 00:00:00
abstract：:Evidence suggests neovascularization is involved in the etiology of spontaneous Achilles tendon rupture. Therefore we investigated expression of the receptors of one of the most important angiogenic factors, the vascular endothelial growth factor in normal and pathologic human Achilles tendons by immunohistochemical a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200403000-00040
更新日期：2004-03-01 00:00:00
