Cemented hemiarthroplasty versus proximal femoral nail antirotation in the management of intertrochanteric femoral fractures in the elderly: a case control study

Jin, Zhuangzhuang; Xu, Shuoyan; Yang, Yue; Wei, Yuansong; You, Tian; Wang, Ziyuan; Bai, Lan

doi:10.1186/s12891-021-04586-x

Cited by 4 publications

(4 citation statements)

References 33 publications

(42 reference statements)

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“…Recent studies have suggested that LCHA replacements have fewer postoperative complications than intramedullary nailing for treating IFF in older adults [5,8,23]. However, Tang et al found no signi cant difference in postoperative complications between the two groups of patients [24].…”

Section: Discussionmentioning

confidence: 99%

Two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation versus long-stemmed cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in Patients 75 Years and Older: a retrospective study

Deng,

Zhou,

Sun

et al. 2023

Preprint

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Background: As the population continues to age, the occurrence of intertrochanteric femoral fractures (IFF) has been steadily increasing. Presently, the primary surgical treatment modality for this condition is intramedullary nailing fixation. However, primary cemented hemiarthroplasty is being considered a viable treatment option. The main aims of this investigation were to evaluate and draw comparisons between the clinical outcomes, ambulatory ability, overall survival, and all-cause mortality between two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation (IF) and long-stemmed cemented bipolar hemiarthroplasty (LCHA) treatment of IFF in patients aged 75 years and older. The secondary objective was investigating relative independent risk factors contributing to postoperative all-cause mortality. Methods: A retrospective analysis was conducted on 251 elderly patients (≥ 75 years) with IFF who underwent IF or LCHA between January 2018 and October 2022. We employed generalized estimating equations along with univariate and multivariate analyses to examine the impact of various surgical interventions and other pertinent factors on postoperative ambulatory ability and all-cause mortality outcomes. Associations between sex, age, number of comorbidities, aspartate aminotransferase (AST) levels, total blood transfusions, and mortality were analysed using Cox proportional hazards models. Results: The analysis included a cohort of 120 patients from the IF group and 121 patients from the LCHA group. Statistically significant differences were not observed in the clinical outcomes, ambulatory ability, overall survival, or all-cause mortality after surgical treatment between the groups receiving IF and LCHA (p > 0.05).Nevertheless, among patients (age ≥ 85 years),the IF group demonstrated a lower rate of all-cause mortality compared to the LCHA group (p < 0.05). The older the patient, the greater the number of preoperative comorbidities and amount of perioperative transfusion; a lower preoperative AST level was associated with a higher risk of postoperative death (p < 0.05). Conclusions: The results imply that the choice of IF or LCHA treatment for elderly patients with IFF aged 75 years or older may need to be tailored to the number of preoperative comorbidities, sex, age, preoperative AST level, and cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation versus long-stemmed cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in Patients 75 Years and Older: a retrospective study

Deng,

Zhou,

Sun

et al. 2023

Preprint

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“…Sinno 2010 [86] ✓ (A) Bansal 2019a [50] ✓ (A) Jin 2021 [67] ✓ (A) Soreide 1979 [87] − Magu 2008 [75] ✓ (A) Mansukhani 2017 [102] ✕ Table 3. Counts of reported surgical-related barriers and facilitators with a positive association (), negative association (), or absence of an association (-), with weight bearing after hip fracture surgery.…”

Section: Discussionmentioning

confidence: 99%

Barriers and facilitators of weight bearing after hip fracture surgery among older adults. A scoping review

et al. 2023

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“…Cemented endoprostheses can be beneficial in patients with a thin cortical bone structure to reduce the risk of periprosthetic fractures. Cement application, on the other hand, may increase cardiopulmonary risks in such patients [ 26 , 27 ]. Aside from the bone loss, there are studies suggesting the use of larger femoral stems with long calcar support, due to the wide femoral canal observed in older adult patients [ 26 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Primary Arthroplasty or Internal Fixation in Intertrochanteric Femur Fractures: A Survey of Surgical Attitudes of Orthopedic Surgeons in Turkey

Cici

Bektaş²,

Demirkıran³

et al. 2022

Geriatrics

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This study aimed to examine the primary arthroplasty attitudes of Turkish orthopedics and traumatology specialists and residents to patients with intertrochanteric fractures, of various ages, comorbidity situations and fracture types, using an internet-based questionnaire. Between March and April 2021, a cross-sectional survey was conducted with a total of 159 orthopedics and traumatology specialists and residents in Turkey, using an online questionnaire that consisted of 16 different patient scenarios of varying intertrochanteric fracture types, ages, and comorbidity conditions. Respondents’ preference ratio for primary arthroplasty was 24.1% in the scenarios with patients over the age of 71, while it was 8.4% in the scenarios with patients aged between 50 and 70. The ratios of primary arthroplasty preference were 12.4%, 21% and 27.3% in 2-part, 3-part and 4-part fracture scenarios, respectively. The primary arthroplasty preferences of respondents with 10 years or more of professional experience were observed to be statistically significantly different to those of the respondents with 1 to 10 years of experience in the 4-part fracture scenario where the patient was aged 71 years and above with an ASA (American Society of Anesthesiologists) score of 3–4 (p < 0.05). Despite varying opinions in the literature in recent years, primary arthroplasty can be considered a valuable alternative approach for Turkish surgeons, and in older adult patients with unstable intertrochanteric fractures, particularly those who need early mobilization and have high ASA scores.

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Cemented hemiarthroplasty versus proximal femoral nail antirotation in the management of intertrochanteric femoral fractures in the elderly: a case control study

Cited by 4 publications

References 33 publications

Two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation versus long-stemmed cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in Patients 75 Years and Older: a retrospective study

Two cephalic screws combined compression proximal-femur intramedullary nailing internal fixation versus long-stemmed cemented bipolar hemiarthroplasty for treating intertrochanteric fractures in Patients 75 Years and Older: a retrospective study

Barriers and facilitators of weight bearing after hip fracture surgery among older adults. A scoping review

Primary Arthroplasty or Internal Fixation in Intertrochanteric Femur Fractures: A Survey of Surgical Attitudes of Orthopedic Surgeons in Turkey

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