Iranian Journal of Orthopedic Surgery

Abstract Abstract
Introduction: Intertrochanteric femoral fractures are common and can be associated with significant complications and mortality. This study aimed to assess the mortality rate and related factors in patients undergoing surgical treatment for intertrochanteric fractures.
Materials & Methods: This retrospective descriptive-analytical study included patients with intertrochanteric hip fracture who underwent surgery between 2017 and 2018 in a teaching hospital .The demographic data were collected from patients’ records, with specific attention to age, osteoporosis, previous fracture history, cognitive disorders, hypertension, delay in surgery, and the type of fixation implant. Mortality status was assessed through follow-up phone calls. Data were analyzed using STATA software and logistic regression analysis.
Results & Discussion: 227 case within one year were studied. The overall mortality rate was 16.3%. In the deceased (p<0.05). Logistic regression revealed that advanced age, osteoporosis, previous fracture history, cognitive disorders, history of falling, surgical delay, and type of surgery were independent predictors of mortality (p<0.05).
Conclusion: Postoperative mortality following intertrochanteric fracture surgery is influenced by a range of clinical and modifiable factors. Timely selection of an appropriate surgical method and identification of high-risk patients can play a significant role in improving treatment outcomes.
 

Abstract Background: We aim to evaluate the epidemiology and pattern of pediatric traumatic deaths in our city in a developing middle eastern country, Iran, during the period 2011-2020, in light of the importance of pediatric trauma information and mortality.
Methods: Present study is a retrospective cross-sectional study including children and adolescents admitted to our tertiary trauma hospital between 2011 and 2020. Information from the clinical profiles of 16413 children was gathered and analyzed, including demographics, injury type and mechanism, referral method, and site of injuries.
Results: 151 (0.92%) deaths related to trauma were identified, 128 (84.7%) were boys and 23 (15.3%) were girls (P = 0.033). The mean age of children with and without mortality was 10.0 ± 6.1 and 11.0 ± 5.6 years, respectively (P = 0.07). 51 (33.8%) deaths were occurred in children 15-18 years old (P = 0.004).
The highest mortality was in summer with 48 people (31.8%) (P = 0.96). Car accidents with 130 (86%) cases were the most common mechanism (P < 0.001). The most common traumas leading to death were head and neck traumas, with 64 (42.4%) deaths. Regarding the transfer to the hospital, 123 (81.4%) deaths were referred by ambulance, while 28 (18.6%) deaths were referred by personal vehicle (P < 0.001).
Conclusion: Most trauma-related deaths in pediatric and adolescent children in our city, Iran, were boys between 15-18 years of age, had head and neck or chest trauma, referred by ambulance, and caused by traffic accidents on streets, mainly with the car. 0.92% of trauma led to mortality, and the most common cause was head and neck injuries. Traffic accidents, the leading cause of trauma, requires social, legal, and environmental interventions.

Abstract Objective: The aim of this study was to evaluate the effect of various factors on the prognosis of elderly patients with hip fractures to make it easier for physicians and patients to choose the type of surgical or non-surgical treatment with more accurate prognosis.
Methods and materials used: This epidemiological study was performed on patients older than 65 years who presented with a diagnosis of hip fracture within one year. Independent variables including sex, age of the patient, concomitant diseases, time elapsed from fracture to surgery and type of anesthesia were evaluated for Bartel score, postoperative mortality and type of treatment.
Results: The mean age of the study population (163 people) was 7.7 ± 78.7- with the age range of 65-97 which included 91 women (55.8%) and 72 men (44.2%). The highest number of our patients was in the age range of 76 to 85 years (48%). The number of deaths in patients who did not undergo surgery in the first month after the fracture was 3 (۱ 11.5) in femoral neck fractures and 3 (۵ 11.5) in intracentric fractures. In the next eleven months of follow-up, Mir had one patient (۸ 3.8) in femoral neck fractures and three patients (11.5 ٪) in intracentric fractures.
Conclusion: In this study, the age of patients was an important determinant of mortality, so that mortality has increased with age, but the type of gender is not effective in increasing mortality.