Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital

Introduction: Native and prosthetic hip dislocations are emergencies. With an ageing society that is living longer, the increased incidence of hip fracture and resultant prosthetic implantation has led to a rise in prosthetic dislocations. This study will compare patients with hip and prosthetic dis...

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Main Author: Tan, Xuan Hao
Other Authors: Tham Kum Ying
Format: Final Year Project
Language:English
Published: 2017
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Online Access:http://hdl.handle.net/10356/72641
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Institution: Nanyang Technological University
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spelling sg-ntu-dr.10356-726412020-11-01T05:33:22Z Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital Tan, Xuan Hao Tham Kum Ying Lee Kong Chian School of Medicine (LKCMedicine) DRNTU::Science::Medicine Introduction: Native and prosthetic hip dislocations are emergencies. With an ageing society that is living longer, the increased incidence of hip fracture and resultant prosthetic implantation has led to a rise in prosthetic dislocations. This study will compare patients with hip and prosthetic dislocations presenting to Tan Tock Seng Hospital (TTSH) Emergency Department (ED). Methods: A retrospective review was conducted of hip and prosthetic dislocations between 1 Jan 2011 and 31 Dec 2015. Patients below 21 years old were excluded. Using descriptive and summary statistics, these factors were compared: demographics, previous dislocations, aetiology, injury pattern, severity, ED and inpatient management, and complications. Results: Fifty-nine patients (50.8% women) contributed to 81 ED encounters. The ratio of hip to prosthetic dislocation was approximately 1:1. Mean age of women (64.9 years) was significantly higher (p=0.01) than men (51.8 years). A higher proportion (p<0.01) of women (76.6%) had prosthetic dislocation compared to men (44.1%). Conversely, a higher proportion (p<0.01) of men (55.9%) had native dislocation than women (23.4%). Native and prosthetic dislocations were caused by high-energy and lowenergy transfer events respectively. Of the 59 patients, 29 had native dislocation, 17 had first prosthetic dislocation and 13 had recurrent prosthetic dislocation, accounting for 34 ED encounters that ranged from 2 to 6 dislocations/patient. Mean age of recurrent prosthetic dislocations was 75.3 years (SD 12.3) and women outnumbered men by 1.6:1. Median hospitalisation duration for native, prosthetic and recurrent prosthetic dislocations were 5 days (IQR 3.25-7.5), 1.5 days (IQR 1-5.25) and 1 day (IQR 1-2) respectively. Conclusion: Native hip dislocations secondary to high-energy transfer events were commoner in younger men who required longer hospitalisation. First and recurrent prosthetic dislocations secondary to low-energy transfer events were commoner in elderly women who needed short hospitalisation and hence potential for 24-hour admission should be explored for this group. Bachelor of Medicine and Bachelor of Surgery 2017-08-31T07:03:29Z 2017-08-31T07:03:29Z 2017 Final Year Project (FYP) http://hdl.handle.net/10356/72641 en 12 p. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic DRNTU::Science::Medicine
spellingShingle DRNTU::Science::Medicine
Tan, Xuan Hao
Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
description Introduction: Native and prosthetic hip dislocations are emergencies. With an ageing society that is living longer, the increased incidence of hip fracture and resultant prosthetic implantation has led to a rise in prosthetic dislocations. This study will compare patients with hip and prosthetic dislocations presenting to Tan Tock Seng Hospital (TTSH) Emergency Department (ED). Methods: A retrospective review was conducted of hip and prosthetic dislocations between 1 Jan 2011 and 31 Dec 2015. Patients below 21 years old were excluded. Using descriptive and summary statistics, these factors were compared: demographics, previous dislocations, aetiology, injury pattern, severity, ED and inpatient management, and complications. Results: Fifty-nine patients (50.8% women) contributed to 81 ED encounters. The ratio of hip to prosthetic dislocation was approximately 1:1. Mean age of women (64.9 years) was significantly higher (p=0.01) than men (51.8 years). A higher proportion (p<0.01) of women (76.6%) had prosthetic dislocation compared to men (44.1%). Conversely, a higher proportion (p<0.01) of men (55.9%) had native dislocation than women (23.4%). Native and prosthetic dislocations were caused by high-energy and lowenergy transfer events respectively. Of the 59 patients, 29 had native dislocation, 17 had first prosthetic dislocation and 13 had recurrent prosthetic dislocation, accounting for 34 ED encounters that ranged from 2 to 6 dislocations/patient. Mean age of recurrent prosthetic dislocations was 75.3 years (SD 12.3) and women outnumbered men by 1.6:1. Median hospitalisation duration for native, prosthetic and recurrent prosthetic dislocations were 5 days (IQR 3.25-7.5), 1.5 days (IQR 1-5.25) and 1 day (IQR 1-2) respectively. Conclusion: Native hip dislocations secondary to high-energy transfer events were commoner in younger men who required longer hospitalisation. First and recurrent prosthetic dislocations secondary to low-energy transfer events were commoner in elderly women who needed short hospitalisation and hence potential for 24-hour admission should be explored for this group.
author2 Tham Kum Ying
author_facet Tham Kum Ying
Tan, Xuan Hao
format Final Year Project
author Tan, Xuan Hao
author_sort Tan, Xuan Hao
title Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
title_short Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
title_full Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
title_fullStr Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
title_full_unstemmed Hip and prosthetic dislocation presenting to emergency department of Tan Tock Seng Hospital
title_sort hip and prosthetic dislocation presenting to emergency department of tan tock seng hospital
publishDate 2017
url http://hdl.handle.net/10356/72641
_version_ 1683494010635681792