Differences between intertrochanteric and femoral neck fractures in resuscitative status and mortality rates

Huff, Scott; Henningsen, Joseph; Schneider, Andrew; Hijji, Fady Y.; Froehle, Andrew W.; Krishnamurthy, Anil

doi:10.1016/j.otsr.2022.103231

Cited by 8 publications

(3 citation statements)

References 24 publications

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“…Amongst our studied population, the most common pattern of proximal femur fractures was intertrochanteric (36.1%), followed by femoral neck fractures (33.7%). Similar findings have been reported in previous literature [ 43 – 45 ]. Intertrochanteric fractures were most observed in patients younger than 50 years of age, whereas femoral neck fractures were observed in those older than 50.…”

Section: Discussionsupporting

confidence: 93%

Epidemiology of proximal femur fractures in the young population of Qatar

Hantouly,

AlBarazanji,

Al-Juboori

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose To review the epidemiological characteristics of proximal femur fractures in the young population (< 60 years) of Qatar between 2017 and 2019. Methods All patient treated for proximal femur fractures at Hamad General Hospital (HGH), a level one trauma center, were retrospectively reviewed between Jan 2017 and Dec 2019. All adults (18–60 years) with proximal femur fracture (femur head, femur neck, intertrochanteric and subtrochanteric fractures) were included with no restriction to the AO/OTA classification or fractures subtypes. Excluded cases were pathological fractures, cases with insufficient documentation or no radiographs. Results A total of 203 patients with a mean age of 40.07 ± 11.76 years were included, of who 89.9% were males. The incidence of proximal femur fracture was 3.12/100,000/year. Fall from height (48.1%) followed by road traffic accidents (26.9%) were common cause of injury. The most common fracture type was intertrochanteric fracture (36.1%) followed by femur neck fractures (33.7%). Conclusion This study provides the initial insights into the proximal femur fractures in the young population of Qatar. This is the first study to investigate of the epidemiology of such fractures in this particular patient group. Contrary to the existing literature on older age groups, the majority of the injuries were observed in males. Falls from height followed by road traffic accidents were the primary mechanisms leading to these fractures. Improved understanding of the profile of these injuries can aid in their prevention by implementing more effective safety measures.

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Section: Discussionsupporting

confidence: 93%

Epidemiology of proximal femur fractures in the young population of Qatar

Hantouly,

AlBarazanji,

Al-Juboori

et al. 2023

Eur J Orthop Surg Traumatol

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“…Furthermore, to the authors knowledge, the association of LWT and mortality risk have not been assessed; however, ITF are known to be associated with a higher mortality risk when compared to femoral neck fractures. 8 The primary aim of this study was to validate whether ITF patients with incompetent LWT (< 20.5 mm) had an increased revision risk following SHS fixation when the medial calcar was intact. The secondary aim was to assess whether LWT was associated with patient mortality.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lateral wall thickness is not associated with revision risk of medially stable intertrochanteric fractures fixed with a sliding hip screw

Chen,

Duckworth,

Farrow

et al. 2024

Bone Jt Open

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AimsThis study aimed to determine whether lateral femoral wall thickness (LWT) < 20.5 mm was associated with increased revision risk of intertrochanteric fracture (ITF) of the hip following sliding hip screw (SHS) fixation when the medial calcar was intact. Additionally, the study assessed the association between LWT and patient mortality.MethodsThis retrospective study included ITF patients aged 50 years and over treated with SHS fixation between 2019 and 2021 at a major trauma centre. Demographic information, fracture type, delirium status, American Society of Anesthesiologists grade, and length of stay were collected. LWT and tip apex distance were measured. Revision surgery and mortality were recorded at a mean follow-up of 19.5 months (1.6 to 48). Cox regression was performed to evaluate independent risk factors associated with revision surgery and mortality.ResultsThe cohort consisted of 890 patients with a mean age of 82 years (SD 10.2). Mean LWT was 27.0 mm (SD 8.6), and there were 213 patients (23.9%) with LWT < 20.5 mm. Overall, 20 patients (2.2%) underwent a revision surgery following SHS fixation. Adjusting for covariates, LWT < 20.5 mm was not independently associated with an increased revision or mortality risk. However, factors that were significantly more prevalent in LWT < 20.5 mm group, which included residence in care home (hazard ratio (HR) 1.84; p < 0.001) or hospital (HR 1.65; p = 0.005), and delirium (HR 1.32; p = 0.026), were independently associated with an increased mortality risk. The only independent factor associated with increased risk of revision was older age (HR 1.07; p = 0.030).ConclusionLWT was not associated with risk of revision surgery in patients with an ITF fixed with a SHS when the calcar was intact, after adjusting for the independent effect of age. Although LWT < 20.5 mm was not an independent risk factor for mortality, patients with LWT < 20.5 mm were more likely to be from care home or hospital and have delirium on admission, which were associated with a higher mortality rate.Cite this article: Bone Jt Open 2024;5(2):123–131.

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Recent progress in limb traumatology

Adam

Clavert

2022

Orthopaedics & Traumatology: Surgery & Research

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Differences between intertrochanteric and femoral neck fractures in resuscitative status and mortality rates

Cited by 8 publications

References 24 publications

Epidemiology of proximal femur fractures in the young population of Qatar

Epidemiology of proximal femur fractures in the young population of Qatar

Lateral wall thickness is not associated with revision risk of medially stable intertrochanteric fractures fixed with a sliding hip screw

Recent progress in limb traumatology

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