الفهرس | Only 14 pages are availabe for public view |
Abstract Femoral neck fractures in elderly diabetic patients are complicated injuries that require medical, social and surgical treatment and consume considerable healthcare resources. Femoral neck fractures occur predominantly as low energy trauma in elderly. Approximately 90% of neck femur in this population result from a simple fall. The high prevalence of these injuries in the elderly is related to numerous factors, including osteoporosis and associated medical comorbidites. The current overall 1- year mortality after hip fracture in the elderly population ranges from 12% to 36%. Hemiarthroplasty unipolar or bipolar still one of stronge option in surgical treatment of fracture neck femur in elderly patient to restore the function and early weight bearing and less expensive ,time counsuming surgery if compared with T.H.A. Diabetic patients with both type 1,2 DM are major risk group undergoing major surgery like hemiartroplasty in fracture neck femur. Diabetes mellitus as chronic disease has pathological effect on blood vessels ,nerves , muscle and bone density specially in type 1 DM due to decrease insulin secreation which is an important anabolic agent in young age. So that diabetes mellitus is very serious comorbid condition in orthopedic surgical patient which lead to delayed wound healing , peripheral neuropathy , functional activity of the muscles and risk of bone fracture specially in hip joint of elderly diabetic patients. Adequate preparation to control blood sugar pre,intra and postoperative is very important to decrease the risk of complications post-operative delayed wound healing ,blood loss and superficial ,deep infection which may be the cause of revision surgery. Control blood sugar below 200 mg/dl considered safe zone in diabetic patients who undergoing major surgery like hemiarthroplasty to decease the risk of postoperative infection. Glycosylated heamoglobin considered important guide mark for evaluation blood sugar in previous three months in diabetic patient undergoing major orthopedic surgery like hemiarthroplasty. More than 7% indicate that the blood sugar out of control and need assessment before surgery. |