Clinical Research Directory

Inflammatory Indices, Early Mortality, and ICU Stay in Geriatric PFN Patients

This retrospective observational cohort study aims to evaluate the association between preoperative and postoperative inflammatory indices and early postoperative outcomes in geriatric patients undergoing proximal femoral nailing (PFN) for intertrochanteric femur fractures. The primary outcome of the study is 30-day mortality, while the secondary outcome is intensive care unit (ICU) length of stay. Various inflammatory biomarkers derived from routine laboratory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), immune-inflammatory prognostic index (IPI), aggregate index of systemic inflammation (AIS), and RDW-to-albumin ratio (RAR), will be analyzed to investigate their prognostic value in the acute postoperative period. The study seeks to identify simple and readily accessible biomarkers that may contribute to early risk stratification and perioperative management in elderly hip fracture patients.

Dynamic Versus Static Distal Interlocking In AO/OTA 31A2 Intertrochanteric Femur Fractures: A Prospective Randomized Controlled Trial

AO/OTA 31A2 intertrochanteric femur fractures are unstable injuries commonly treated with cephalomedullary nailing. However, the optimal distal locking configuration for short proximal femoral nails remains uncertain. This prospective, single-center, parallel-group randomized trial compared dynamic and static distal interlocking of a single short proximal femoral nail design in patients aged 65 years or older with AO/OTA 31A2 fractures. A total of 111 participants were randomized in a 1:1 ratio to dynamic or static distal locking and were followed for a minimum of 24 months. The study evaluated hip function, fracture union and time to union, established non-union, cephalic lag-screw backout, distal cortical thickening, peri-implant fracture, and reoperation or revision surgery.

How TENS Affects Pain, Medication Use, and Muscle Function in Older Adults With Hip Fractures

The goal of this clinical trial is to learn if transcutaneous electrical nerve stimulation (TENS) can reduce perioperative pain in older adults with hip fractures. It will also evaluate its effects on physiological and psychological outcomes. The main questions it aims to answer are: Does adding TENS to usual care during the preoperative phase reduce pain intensity and analgesic consumption? Does TENS affect pressure pain threshold and vital signs (blood pressure, heart rate, and respiratory rate)? Researchers will compare active TENS to sham TENS (no perceptible stimulation) to see if TENS is effective in reducing pain and improving related outcomes. Participants will: * Undergo a standardized baseline assessment, including evaluation of pain, vital signs, anxiety, discomfort, and pressure pain threshold * Complete questionnaires assessing quality of life, physical activity, depressive symptoms, anxiety, fear of falling, and pain catastrophizing * Be randomly assigned to receive either active TENS or sham TENS * Receive a single 45-minute TENS session * Have their analgesic use recorded for the 24 hours before and after the intervention.

Intertrochanteric Femur Fracture Patients Who Receive Metformin With a Placebo

The investigators central hypothesis is that metformin supplementation will be well-tolerated, safe, and provide patients with improved functional and muscle morphology outcomes following intertrochanteric femur fracture. The objectives will be tested in older adults that sustain a hip fracture and are randomized to receive a daily oral dose (1.5g daily) of metformin or a non-active placebo during 4 months of recovery following surgery.