DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20221129

Hip fractures associated with concomitant upper limb fractures: a case series

Neetin P. Mahajan, Tushar Patil, Kunal Chaudhari, Kartik Pande

Abstract


Elderly patients are at risk of fractures of distal radius, proximal humerus, spine and hip even due to trivial low energy falls. Hip injuries are commonly associated with concomitant ipsilateral upper limb injury because of a protective reflex of shielding their body from fall using their shoulder or outstretched hand. Here we presented a case series of 3 elderly patients who came to us with hip fractures and concomitant ipsilateral upper limb fractures. The injuries were adequately managed with splintage and operative procedures. Post-operatively mobilization was challenging. But patients were successfully mobilized with the help of relatives and physiotherapists. Concomitant hip fractures with associated ipsilateral upper limb fractures are quite common in elderly and difficult to treat. Post-operatively mobilization of patient and functional outcome is hampered. Proper counselling by operating surgeon, physiotherapy and postoperative rehabilitation with the help of relatives and assisting devices provides good outcome. In cases of hip trauma in old age, one should always thoroughly examine and screen for upper limb injuries. So that early appropriate treatment and mobilization can be done with good functional outcome.


Keywords


Concomitant fractures, Ipsilateral, Hip trauma, Upper limb trauma

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References


Thayer MK, Kleweno CP, Lyons VH, Taitsman LA. Concomitant upper extremity fracture worsens outcomes in elderly patients with hip fracture. Geriat Orthop Surg Rehab. 2018;9:2151459318776101.

Buecking B, Wack C, Oberkircher L, Ruchholtz S, Eschbach D. Do concomitant fractures with hip fractures influence complication rate and functional outcome? Clin Orthop Relat Res. 2012;470(12):3596-606.

Mulhall KJ, Ahmed A, Khan Y, Masterson E. Simultaneous hip and upper limb fracture in the elderly: incidence, features and management considerations. Injury. 2002;33(1):29-31.

Ng A, Mattin A, Seymour H, McKinnon E. Comparison of outcomes between hip fracture patients with concurrent upper limb injuries and patients with an isolated hip fracture. ANZ J Surg. 2019;89(1-2):57-60.

Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R. Concomitant upper limb fractures and short-term functional recovery in hip fracture patients: does the site of upper limb injury matter? Am J Phys Med Rehab. 2015;94(5):366-72.

Uzoigwe CE, Venkatesan M, Johnson N, Lee K, Magaji S, Cutler L. Influence of coincident distal radius fracture in patients with hip fracture: single-centre series and meta-analysis. J Orthop Traumatol. 2015;16(2):93-7.

Dubljanin-Raspopović E, Lj MD, Kadija M, Tomanović Vujadinović S, Tulić G, Selaković I, Aleksić M. Simultaneous Hip and Distal Radius Fractures—Does It Make a Difference with Respect to Rehabilitation? Geriatrics. 2019;4(4):66.

Morris DL, Nightingale JM, Geoghegan JM, Moran CG. Concurrent upper limb and hip fracture in the elderly. Injury. 2020;51(4):1025-30.