Decreasing mortality after femoral neck fracture treated with bipolar hemiarthroplasty during the last twenty years

Schneppendahl, Johannes; Grassmann, Jan-Peter; Петров, В. Г.; Böttner, Friedrich; Körbl, Birthe; Hakimi, M.; Betsch, Marcel; Windolf, Joachim; Wild, Michael

doi:10.1007/s00264-012-1600-z

Cited by 13 publications

(7 citation statements)

References 28 publications

(42 reference statements)

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“…8,9,17,21 The 6-month mortality rate in our series was 6% and 2-year mortality was 10.9% which was toward the lower end of spectrum of the rate reported by other studies (11%-27%). [22][23][24][25] The low mortality in our series could be attributed to the relatively younger cohort with less comorbidities, early surgery with mobilization, VTE prophylaxis, and comprehensive geriatric care. Lim et al observed a raised mortality due to a delay before surgery of more than 5 days.…”

Section: Discussionmentioning

confidence: 97%

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Jain

Selhi

Mears

et al. 2015

Geriatr Orthop Surg Rehabil

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Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for comanagement of these injuries by orthopedic and internal medicine teams at our hospital in India. From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant. The cohort included 63 males and 56 females with a mean age of 70.7 years (range 55-98 years). Hypertension (n ¼ 42) and diabetes mellitus (n ¼ 29) were the most common comorbidities. The follow-up period ranged from 12 to 37 months with an average of 24 months. The surgery was performed within 24 hours of admission in 60.5% (n ¼ 72) patients. The use of antiplatelet drugs was the most common reason for delay of surgery. The mean length of hospital stay was 10.4 days (range 3-24 days) with 77% (n ¼ 92) of patients discharged within 1 week of admission. On follow-up, good to excellent Harris hip scores were seen in 88% of patients with 76% of patients returning to the preinjury ambulatory status. The mortality rate was 6% at 6 months follow-up and 10.9% at 2 years. Our study shows that a hip fracture program can be instituted in India. The program helped us in achieving the goal of early surgery, mobilization, and discharge from hospital with decreased mortality.

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Section: Discussionmentioning

confidence: 97%

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Jain

Selhi

Mears

et al. 2015

Geriatr Orthop Surg Rehabil

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“…In our study, the 1-year mortality rate of the arthroplasty group and conservative group was 12.1 % and 43.4%, respectively. One of the possible reasons for this difference is the surgical treatment of the femoral neck fracture no longer increasing the mortality compared with the general population during the last two decades [31].…”

Section: Discussionmentioning

confidence: 99%

Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

Liu

Zhang

Zhao

2020

Preprint

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Background The aging of the China population is expected to lead to increasing of nonagenarian and centenarian.The mortality rates of nonagenarian hip fracture patients would return to an equivalent mortality risk to the normal population at five years after injury. It is imperative to evaluate the 5-year mortality for this small but very challenging subgroup patients in order to optimize patient management. The main purpose of the current retrospective study was to compare the five-year survival between arthroplasty treatment and conservative treatment of femoral neck fracture patients age over 90 years during the same 16 -year period.Methods From January 1998 to December 2014, all consecutive nonagenarian and centenarian patients with femoral neck fracture admitted to our hospital were included for evaluation. The primary outcome was defined as thirty-day mortality, 1-year, 3-year, and 5-year mortality after injury. Survival status analysis was performed by the Kaplan–Meier method for mortality. Using the log-rank test, the stratified analyses were performed to compare the difference of overall cumulative mortality and three-time points (1-year, 3-year, and 5-year) mortality after injury were performed to compare the difference of survival distributions.Results Over the 16-year study period, the arthroplasty group and the conservative treatment group included 33 and 53 patients, respectively. The long-term survival probability of the arthroplasty group is significantly higher than the conservative treatment group( p=0.002277). The survival time of the arthroplasty group is significantly higher than the conservative treatment group(Median(P75-P25)=53(59) versus Median(P75-P25)=22(52), p=0.001). The difference of five time points (1-year, 2-year, 3-year, 4-year, and 5-year) mortality between the conservative group and arthroplasty group is significant except for 30-day mortality.The stratified analyses of overall cumulative mortality and three-time points (1-year, 3-year, and 5-year) mortality after injury demonstrated that the arthroplasty group is significant higher than the conservative treatment group.Conclusions Our study demonstrate that, compared with conservative treatment, arthroplasty surgery is more likely to improve the long-term survival of femoral neck fracture patients over 90s. What can be expected is that nearly half of patients will survive more than five years after surgery.

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“…According to our results, more biomechanical experiments investigating fixation of fractures with a posterior comminution defect are necessary. To explore the risk of construct failure with associated complicated endoprosthetic replacements, in vivo studies are required to analyze clinical outcomes after fixation of intertrochanteric fractures with the InterTAN and PFNA devices; few reports [27] were found and there is no consensus, and surgical preference may play a role [28][29][30]. Preclinical discovery of potential harmful qualities of orthopaedic devices should impede clinical use.…”

Section: Discussionmentioning

confidence: 99%

A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures

Huang

Zhang

Luo

2013

International Orthopaedics (SICOT)

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Comparison of the treatment of intertrochanteric fractures with InterTAN and PFNA internal fixation showed that the InterTAN yielded improvement relative to the PFNA. InterTAN has a firmer and biomechanically superior performance and is therefore an ideal internal fixation method for treating intertrochanteric fractures. Additional research in osteopenic bone is necessary to comprehensively characterize the effects of the design enhancements of these two implants.

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Decreasing mortality after femoral neck fracture treated with bipolar hemiarthroplasty during the last twenty years

Cited by 13 publications

References 28 publications

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Long-term survival of femoral neck fracture patients age over ninety: Arthroplasty compare with conservative treatment

A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures

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