Browsing by Author "Schweitzer, Daniel"

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    Comparison of complications and length of hospital stay between orthopedic and orthogeriatric treatment in elderly patients with a hip fracture
    (2012) Wagner, P.; Fuentes, P.; Diaz, A.; Martinez, F.; Amenábar Edwards, Pedro Pablo; Schweitzer, Daniel; Botello Correa, Eduardo; Gac Espínola, Homero
    Hip fractures in the elderly individuals are a complex problem. Our objective was to determine whether orthogeriatric treatment is effective in terms of reducing length of hospital stay, morbidity, and mortality of elderly patients with a hip fracture compared with orthopedic (traditional) treatment. From July 2009 to May 2011, patients older than 65 years with a hip fracture were followed prospectively. They were co-treated by geriatric and orthopedic teams. This cohort was compared with a retrospective cohort followed from January 2007 to June 2009 that was managed by the orthopedic surgery team only. Epidemiology, pre- and postoperative hematocrit, and renal function were registered. Also, in-hospital and distant mortality data (determined by consulting the national registry), mortality-associated factors, postoperative complications, hospital stay length, and transfers to other services were registered. One hundred and eighty-three patients in the retrospective group and 92 in the prospective group were included in this study with a median follow-up of 26 months (interquartile range: 13-41). The average age was 84 years and 74% of patients were female. Intertrochanteric fracture accounted for 51% of the cases. There was no difference between groups with regard to hospital stay length, hematocrit at discharge, in-hospital mortality, long-term survival, or transfers to internal medicine or the intensive care unit. It did show differences in the transfer to the intermediate care unit, prolonged hospitalizations (>20 days), and diagnosis of delirium and anemia requiring transfusion. In the present study, orthogeriatric treatment is slightly more effective than traditional treatment in terms of morbidity, but there is no difference in hospital stay length or mortality. Further studies and longer follow-up are needed to draw more conclusions.
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    Do Orthopaedic Oncologists Agree on the Diagnosis and Treatment of Cartilage Tumors of the Appendicular Skeleton?
    (2017) Zamora Helo, Tomás; Urrutia Escobar, Julio Octavio; Schweitzer, Daniel; Amenábar Edwards, Pedro Pablo; Botello Correa, Eduardo
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    Factors associated with avascular necrosis of the femoral head and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation
    (2013) Schweitzer, Daniel; Melero, P.; Zylberberg, A.; Salabarrieta, J.; Urrutia Escobar, Julio Octavio
    Introduction: Few studies have evaluated treatment of displaced femoral neck fractures in patients younger than 65 years, and risk factors for AVN or nonunion have not been clearly delineated within this age range. METHOD: To determine factors associated with avascular necrosis of the femoral head (AVN) and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation, we conducted a retrospective study of 29 displaced femoral neck fractures in 29 consecutive patients treated at a single institution. The influence of age, trauma energy, open reduction, and time from fracture to treatment on development of AVN and nonunion was evaluated. RESULTS: Patients who developed AVN were significantly older and suffered lower energy trauma than cases without AVN. No recorded variables were associated with nonunion. Logistic regression determined that only age was independently associated with AVN. Age was a good predictor for developing AVN, with a C statistics of 0.861, and a best cutoff determined at 53.5 years. CONCLUSION: Patients between 53.5 and 65 years presented a higher risk of AVN. A primary arthroplasty should be considered in this subgroup.Introduction: Few studies have evaluated treatment of displaced femoral neck fractures in patients younger than 65 years, and risk factors for AVN or nonunion have not been clearly delineated within this age range. METHOD: To determine factors associated with avascular necrosis of the femoral head (AVN) and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation, we conducted a retrospective study of 29 displaced femoral neck fractures in 29 consecutive patients treated at a single institution. The influence of age, trauma energy, open reduction, and time from fracture to treatment on development of AVN and nonunion was evaluated. RESULTS: Patients who developed AVN were significantly older and suffered lower energy trauma than cases without AVN. No recorded variables were associated with nonunion. Logistic regression determined that only age was independently associated with AVN. Age was a good predictor for developing AVN, with a C statistics of 0.861, and a best cutoff determined at 53.5 years. CONCLUSION: Patients between 53.5 and 65 years presented a higher risk of AVN. A primary arthroplasty should be considered in this subgroup.
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    High prevalence of deep vein thrombosis in elderly hip fracture patients with delayed hospital admission
    (2020) Bengoa, Francisco; Vicencio, Gerardo; Schweitzer, Daniel; Lira, Maria Jesus; Zamora, Tomas; Klaber, Ianiv
    Purpose Deep vein thrombosis (DVT) is a common complication in hip fracture patients, associated with significant morbidity and mortality. Research has focused on postoperative DVT, with scant reports on preoperative prevalence. The aim of this study was to describe the prevalence of preoperative DVT in patients accessing medical care >= 48 h after a hip fracture. Methods We included elderly patients admitted >= 48 h after sustaining a hip fracture, between September 2015 and October 2017. Patients with a previous episode of DVT, undergoing anticoagulation therapy, with pathologic fractures or undergoing cancer treatment were excluded. Of 273 patients, 59 were admitted at least 48 h after the fracture. DVT screening by Doppler ultrasound of both lower extremities was carried upon hospital admission. We recorded age, sex, Charlson comorbidity index and ASA score, fracture type, time since injury, time from admission to surgery and total length of hospital stay. Results We studied 41 patients, 79 (+/- 10.34) years old. The delay from injury to admission was 120 h (48-696 h). Seven patients (17.1%) had a DVT upon admission. There were no significant differences between patients with and without DVT, regarding time from admission to surgery or the total length of the hospital stay. Conclusions The prevalence of DVT in patients admitted >= 48 h after a hip fracture was 17.1%. The diagnosis and management of DVT did not increase time to surgery or hospital stay. Our results suggest routine screening for DVT in patients consulting emergency services >= 48 h after injury.
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    Inter and intra-observer agreement evaluation of the AO and the Tronzo classification systems of fractures of the trochanteric area
    (2015) Urrutia Escobar, Julio Octavio; Zamora Helo, Tomás; Besa, Pablo; Zamora Helo, Maximiliano; Schweitzer, Daniel; Klaber Rosenberg, Ianiv
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    Management of hip fractures in the elderly. A national survey among Chilean orthopaedic surgeons
    (2019) Zamora Helo, Tomás; Klaber Rosenberg, Ianiv; Bengoa, F.; Botello Correa, Eduardo; Schweitzer, Daniel; Amenábar Edwards, Pedro Pablo
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    Methicillin-resistant Staphylococcus aureus colonization in patients undergoing primary total hip arthroplasty
    (2020) Schweitzer, Daniel; Klaber Rosenberg, Ianiv; García Muñoz, Patricia; López, F.; Lira Salas, María Jesús; Botello Correa, Eduardo
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    Nutrition and Inflammation Influence 1-Year Mortality of Surgically Treated Elderly Intertrochanteric Fractures : A Prospective International Multicenter Case Series
    (2019) Belangero, W.; Barla, J.D.; Rienzi Bergalli, D.H.; Olarte Salazar, C.M.; Schweitzer, Daniel; Mite Vivar, M.A.; Zylberberg, A.; Carabelli, G.S.; Kfuri, M.
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    Perioperative care of older patients with hip fractures
    (2017) Bengoa, Francisco; Carrasco Gorman, Marcela; Amenábar Edwards, Pedro Pablo; Schweitzer, Daniel; Botello Correa, Eduardo; Klaber Rosenberg, Ianiv
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    Prevalencia de insuficiencia y deficiencia de vitamina D en adultos mayores con fractura de cadera en Chile
    (2016) Schweitzer, Daniel; Amenábar Edwards, Pedro Pablo; Botello Correa, Eduardo; López, M.; Saavedra, Y.; Klaber Rosenberg, Ianiv
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    Radiographic Assessment of Bone Quality Using 4 Radiographic Indexes: Canal Diaphysis Ratio Is Superior
    (2024) Faundez, Jorge; Carmona, Maximiliano; Klaber, Ianiv; Zamora, Tomas; Botello, Eduardo; Schweitzer, Daniel
    Background: Osteoporosis increases the risk of periprosthetic fracture and loosening in hip arthroplasty. Many methods have been proposed to assess bone quality in X-rays, including both qualitative such as the Dorr classification and quantitative such as the Calcar-Canal Ratio (CCR) and Cortical -Thickness index/Canal-Bone ratio (CTI/CBR). The Canal-Diaphysis ratio (CDR) has been described as a predictor for hip fragility fractures; however, its relationship with bone mineral density (BMD) has not been described. The purpose of this study was to evaluate the correlation of the Dorr classification, CCR, CTI/CBR, and CDR with BMD of the proximal femur in patients without hip fracture. Methods: Forty-seven patients over 45 years of age who had less than 6 months between radiographs and dual -energy X-ray absorptiometry were evaluated. Measurements of CCR, CBR, CDR, and Dorr classification were performed in all radiographs by 2 independent observers. Results: The CDR had a high correlation (r = 0.74, P=<0.01) with BMD, whereas the CTI/CBR had a moderate correlation (r = 0.49, P=<0.01), and the CCR had no correlation with BMD (r = 0.06, P = .96). When evaluating the receiver operating characteristic curve, CDR showed the best performance (area under curve [AUC] = 0.75) followed by CBR (AUC = 0.73) and CCR (AUC = 0.61). The optimal cutoff value for the CDR was 0.49, with 100% sensitivity and 58% specificity. The inter- and intra-observer variability was good for all methods. No differences were found between Dorr classification of patients who had or did not have osteoporosis. Conclusion: Of all the analyzed methods, the CDR was found to have the best correlation with BMD. This study proposes the use of CDR as a tool for assessing bone quality when deciding the implant fixation method in hip arthroplasty. (c) 2023 Elsevier Inc. All rights reserved.
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    Surgical dislocation of the hip without trochanteric osteotomy
    (2017) Schweitzer, Daniel; Klaber Rosenberg, Ianiv; Zamora Helo, Tomás; Amenábar Edwards, Pedro Pablo; Botello Correa, Eduardo
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    Surgical light handles : a source of contamination in the surgical field
    (2015) Schweitzer, Daniel; Klaber Rosenberg, Ianiv; Fischman, Daniel; Wozniak Banchero, Aniela; Botello Correa, Eduardo; Amenábar Edwards, Pedro Pablo
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    The influence of the CT scan in the evaluation and treatment of nondisplaced femoral neck fractures in the elderly
    (2019) Zamora Helo, Tomás; Klaber Rosenberg, Ianiv; Ananías, J.; Bengoa, F.; Botello Correa, Eduardo; Amenábar Edwards, Pedro Pablo; Schweitzer, Daniel
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    Traction images heavily influence lateral wall measurement in trochanteric hip fractures. A prospective study
    (2023) Carmona, Maximiliano; Gonzalez, Nicolas; Segovia, Javier; de Amesti, Martin; Zamora, Tomas; Schweitzer, Daniel
    Introduction: hip fracture represents a global health problem, with a high morbidity and mortality rate and an increasing incidence. The treatment of trochanteric fractures is reduction and osteosynthesis, and implant selection depends mainly on the stability of the fracture and lateral wall competence. Lateral wall competence has gained relevance in recent years, which led to the modification of the AO/OTA classification. However, determination of lateral wall integrity is difficult from plain radiographs; the influence of images with traction on its measurement has not been evaluated.