Shadia Mikhail

The present generation of those past age 70 grew up with the idea that a fractured hip meant "the beginning of the end" for the elderly. The results reported here on the treatment of 50 consecutive patients over 70 years of age who had sustained a fractured hip indicate that in this situation the orthopedic surgeon can be an important partner in geriatric medicine. He can improve the functioning and health of this special group of elderly trauma victims through reassuring them that the fracture usually can be successfully treated without undue risk to life. The present improved state of the art of anesthesiology, surgery, and pre- and postoperative medical care makes the surgical risk tolerable, and helps to prevent many of the complications that used to occur in elderly patients confined to bed for long periods following hip fracture.

Evaluated 40 low back pain patients by a multidisciplinary team (orthopedic surgeons, nursing staff and a medical psychologist) to identify the behavioral characteristics associated with functional and organic determinants of pain. Significant relationships were found between orthopedists' clinical judgments and higher scores on MMPI scales F, HS, and MA, between nurses' ratings and higher scores on MMPI scales D, PA, PT, and SI, and on the Zung Depression Scale and STAI Trait-Anxiety scale. Physicians and nurses consensually agreed on 27 cases. Behavioral observations of the orthopedists and the nursing staff revealed contrasting patterns of behavior for those patients classified as organic or functional. The power of the consensual rating method and its usefulness in clinical appraisals were discussed.