MORTALITY PATTERNS FOLLOWING INTERNAL FIXATION FOR ACUTE FEMORAL NECK FRACTURES IN THE ELDERLY WITH SPECIAL EMPHASIS ON POTENTIAL EXCESS MORTALITY FOLLOWING REOPERATIONS

1980 ◽  
Vol 9 (1) ◽  
pp. 59-63 ◽  
Author(s):  
ODD SÖREIDE ◽  
JOSTEIN LILLESTÖL
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Excess Mortality ◽  
The Elderly ◽  
Femoral Neck Fractures

216 Fix or Replace: Is Internal Fixation Still A Viable Option in The Elderly with Un-Displaced Intracapsular Femoral Neck Fractures?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Morris ◽  
A Krishna ◽  
H Hamid ◽  
M Chawda ◽  
H Mumtaz
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Revision Surgery ◽  
Retrospective Review ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Type I ◽  
Cannulated Screws ◽  
Viable Option ◽  
Displaced Femoral Neck Fractures

Abstract Aim The treatment of impacted or un-displaced femoral neck fractures in the elderly osteoporotic patient is still largely debated, with arthroplasty versus internal fixation two surgical options1. Our aim was to retrospectively review patients over the age of 80 with un-displaced intracapsular hip fractures who had undergone internal fixation and assess their rate of mortality and revision surgery. Method We conducted a retrospective review of all patients with femoral neck fractures over a 4-year period between January 2015 to December 2018. We refined this to only patients over the age of 80 with un-displaced intracapsular femoral neck fractures fixed with cannulated screws. We noted their mental and mobility status, their follow-up attendance over 3 years, their mortality and rate of revision surgery. Results There were a total of 1232 femoral neck fractures in a 4-year period. Of these, 37 were >80 with un-displaced intracapsular femoral neck fractures, with 23 fixed with cannulated screws and 14 with a Dynamic Hip Screw. Mean age – 85, M:F (1:4.75). All patients were either Garden Classification Type I or II. 4% had cognitive impairment. All patients were independently mobile. 83% were followed up for 3 years, with 1 patient (4%) undergoing revision surgery 3 years following cannulated screw fixation. The 30-day mortality rate was 5%. Conclusions The treatment choice for un-displaced intracapsular femoral neck fractures in the elderly remains debateable. Our retrospective review shows that the rate of re-operation is low in patients who have undergone fixation with cannulated screws and so this remains a viable option.

scholarly journals The choice of screw internal fixation and hemiarthroplasty in the treatment of femoral neck fractures in the elderly: a meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Shuai Cui ◽  
Dehui Wang ◽  
Xuejie Wang ◽  
Zehui Li ◽  
Wenlai Guo
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Replacement ◽  
Operation Time ◽  
The Elderly ◽  
Reoperation Rate ◽  
Femoral Neck Fractures ◽  
Controlled Trials ◽  
Short Term ◽  
Randomized Controlled

Abstract Background Femoral neck fractures are common fractures in the elderly. Common treatment options include internal fixation (IF) and hemiarthroplasty (HA). However, the clinical application of these two options is always controversial due to the potential clinical trauma, postoperative function, early complications, and other factors. Materials and methods Randomized controlled trials and cohort studies comparing screw fixation and hemiarthroplasty in elderly patients with displaced femoral neck fractures were extracted from databases such as PubMed, Web of Science, EMBASE, and Cochrane. The revised Jadad scale or NOS treatment evaluation form was used to evaluate the quality of the included studies. After extracting the data, the standard deviation of continuous data and the relative risk of binary data were used. The operation time, blood loss during operation, EQ-5D (EuroQol-5 Dimension) score, mortality rate, reoperation rate, and postoperative common complications were reviewed using Review Manager software (RevMan 5.3) were compared. Results There were 7 randomized controlled trials and 5 cohort studies. The results showed that the operation time, intraoperative blood loss, and short-term EQ-5D score of the internal fixation group were lower than those of the hemi-hip replacement group, but the reoperation rate was higher. There was no statistically significant difference in mortality and common complications such as deep vein thrombosis, pulmonary embolism, infection, and pressure sores during short-term follow-up. Conclusions In the treatment of elderly femoral neck fractures, the screw internal fixation group has shorter operation time and less intraoperative bleeding, and the perioperative advantage is more obvious. However, the hemi-hip replacement group had more advantages in postoperative functional scoring and reoperation.

Internal Fixation Versus Arthroplasty for the Treatment of Nondisplaced Femoral Neck Fractures in the Elderly

2020 ◽  
Vol 34 (1) ◽  
pp. 42-48 ◽  
Author(s):  
John T. Richards ◽  
Archie L. Overmann ◽  
Nathan N. OʼHara ◽  
Jean-Claude DʼAlleyrand ◽  
Gerard P. Slobogean
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
The Elderly ◽  
Femoral Neck Fractures

Outcomes of nondisplaced intracapsular femoral neck fractures with internal screw fixation in elderly patients: a systematic review

2017 ◽  
Vol 28 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Ignacio J. Oñativia ◽  
Pablo A.I. Slulittel ◽  
Fernando Diaz Dilernia ◽  
Juan M. Gonzales Viezcas ◽  
Valeria Vietto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
The Elderly ◽  
Reoperation Rate ◽  
Femoral Neck Fractures ◽  
Displaced Femoral Neck Fractures

Introduction: Although the preferred treatment for displaced femoral neck fractures in the elderly is hip arthroplasty, the treatment for impacted or undisplaced femoral neck fractures (UFNF) is still a subject of controversy. Our purpose was to systematically review studies of elderly patients with UFNF treated with internal fixation using screws: (i) what is the reported mortality; (ii) what is the reoperation rate; (iii) what are the clinical and radiological outcomes; and (iv) what is the methodological quality of the included studies? Methods: This systematic review was performed through a search of PubMed and the Cochrane database using a structured search algorithm including studies enrolling patients older than 60 years old, with UFNF treated with internal fixation using screws. Our literature search returned 950 studies and 11 were selected for final abstraction. Results: 6 studies reported mortality rate. At 1-year follow-up mortality was reported by 3 studies: 18.8%; 22%, and 19%. At 5 years, 1 study reported mortality rate of 42%. Overall reoperation rate was reported by 9 studies and ranged from 8%-19%, while conversion to hip arthroplasty was performed in the range between 8% and 16% according to 6 studies. Conclusions: Internal fixation with cannulated screws for UFNF in the elderly is a valuable option, although it has substantial reoperation and mortality rates. Further prospective high-quality, randomised controlled trials are required to establish the optimal approach for the treatment of UFNF.

scholarly journals Fractures of the proximal femur in the elderly in a sub-Saharan country

2020 ◽  
Vol 7 (1) ◽  
pp. 19
Author(s):  
Ferdinand N. Mebouinz ◽  
Joseph D. Diouf ◽  
Jean C. Sane ◽  
Souleymane Diao ◽  
Amadou Kasse ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Proximal Femur ◽  
The Elderly ◽  
Gamma Nail ◽  
Femoral Neck Fractures ◽  
Sub Saharan Africa ◽  
Proximal Femur Fracture ◽  
Pertrochanteric Fractures ◽  
Sub Saharan

<p class="abstract"><strong>Background:</strong> The aim of this study was to describe the epidemiological, radiographic and therapeutic profile of the fractures of the proximal femur in the elderly in a sub-Saharan country.</p><p class="abstract"><strong>Methods:</strong> A retrospective longitudinal study was carried out at the orthopedic trauma department of Idrissa Pouye Hospital in Senegal. Sixty-six patients recruited were aged at least 90 years; and treated for proximal femur fracture between 2008 and 2017.<strong></strong></p><p class="abstract"><strong>Results:</strong> The median age of the patients was 91 years (90-107). Females represented 54.5%. The fracture was located in the right 65.2%. Femoral neck fractures were 53% predominant with 94.3% type IV according to Garden’s classification. Concerning the 31 patients with a pertrochanteric fractures, 61.3% were stable and 38.7% unstable. The time taken for seeking hospital care was an average of 5.8±9.7 days. All patients had a preoperative anesthesic score less than 4 according to the American society of anesthesiologists (ASA). The therapeutic indication was functional in 15.1% of cases, surgical by internal fixation in 39.2% and by arthroplasty in 45.7% of cases. Pertrochanteric fractures were managed by a dynamic hip screw (DHS) in 68.2% and by gamma nail in 18.2%. Femoral neck fractures were managed by Moore's arthroplasty in 93.3% and by bipolar hip prothesis (BHP) in 6.7%.</p><p class="abstract"><strong>Conclusions:</strong> Fractures of the proximal femur represent a growing problem in sub-Saharan Africa. For patients above 90 years, the management remains essentially surgical by internal fixation in pertrochanteric fractures or by arthroplasty in cervical fractures.</p>

Internal Fixation of Undisplaced Femoral Neck Fractures in the Elderly: A Retrospective Comparison of Fixation Methods

2008 ◽  
Vol 64 (1) ◽  
pp. 155-162 ◽  
Author(s):  
Yih-Shiunn Lee ◽  
Shih-Hao Chen ◽  
Yang-Hwei Tsuang ◽  
Hui-Ling Huang ◽  
Ting-Ying Lo ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
The Elderly ◽  
Femoral Neck Fractures ◽  
Fixation Methods ◽  
Retrospective Comparison

scholarly journals Arthroplasty versus internal fixation for femoral neck fractures in the elderly

2011 ◽  
Vol 6 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Vassilios Nicolaides ◽  
Spyridon Galanakos ◽  
Andreas F. Mavrogenis ◽  
Vasileios I. Sakellariou ◽  
Ioannis Papakostas ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
The Elderly ◽  
Femoral Neck Fractures
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