Displaced femoral neck fractures in patients 60-69 years old – treatment and patient reported outcomes in a register cohort

Lagergren, Johan; Möller, Michael; Rogmark, Cecilia

doi:10.1016/j.injury.2020.08.004

Cited by 11 publications

(11 citation statements)

References 27 publications

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“…The response rate is monitored continuously on the website at unit level and ranges from approximately 65% as its best at injury time and 15% as the lowest at 1 year, depending on age group, fracture type and department. Studies evaluating PROM results and response rates in the SFR are ongoing, but only a few have so far been published [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register

Möller

Wolf

Bergdahl

et al. 2022

BMC Musculoskelet Disord

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Background Before the creation of the Swedish Fracture Register (SFR), there was no national quality register that prospectively collects data regarding all types of fractures regardless of treatment in an emergency setting. Observational data on fractures registered in a sustainable way may provide invaluable tools for quality improvements in health care and research. Description Ten years after its implementation, the Swedish Fracture Register has 100% coverage among orthopaedic and trauma departments in Sweden. The completeness of registrations reached in 2020 69–96% for hip fractures at the different departments, with the majority reporting a completeness above 85%. The Swedish Fracture Register is a fully web-based national quality register created and run by orthopaedic professionals, with financial support from public healthcare providers and the government. All users have full access to both the registration platform and all aggregated statistics in real time. The web-based platform was created for use in health quality registers and it has easily gained acceptance among users. The register has gradually developed by the addition of more fracture types and skeletal parts. Research activity is high and 31 scientific publications have been published since 2016. The strategy from the start was to publish validation data and basic epidemiological data. However, over the past few years, publications on outcomes, such as re-operations and mortality, have been published and four register-based, randomised, controlled trials are ongoing. Conclusion It is possible to create a fracture register, to gain professional acceptance and to collect fracture data in a sustainable way on a national level if the platform is easy to use. Such a platform can also be used as a randomisation platform for prospective studies.

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Section: Introductionmentioning

confidence: 99%

The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register

Möller

Wolf

Bergdahl

et al. 2022

BMC Musculoskelet Disord

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“…HHS is a commonly used index to evaluate the postoperative function of patients with femoral neck fractures. Postoperative HHS has been statistically significant in many meta-analyses [ 3 , 4 , 11 ]. In a study by Gao et al [ 51 ], the HHS of patients undergoing joint replacement was generally higher than that of patients treated with internal fixations, which is consistent with the meta-analysis of Burgers et al [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review

et al. 2022

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Background Femoral neck fractures have a higher incidence in older people with poor prognosis, inducing serious social problems. Common treatment methods include total hip arthroplasty, bipolar hemiarthroplasty, double-screw fixation, multiple-screw fixation, and dynamic hip system. Methods We searched through four electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase databases, for articles regarding femoral neck fractures, bone screw, and hip prosthesis published up to February 11, 2020. All included articles were used for quality evaluation and data extraction. Extracted data were expressed as odds ratios or weighted mean differences, with 95% confidence intervals. We conducted a network meta-analysis for Harris hip score, complications, 1-year mortality rate, reoperation rate, intraoperative blood loss, and duration of operation using STATA version 16.0 software. Results Twenty-two randomized controlled trials and nine cohort studies included in this study involved 3861 patients. Total hip arthroplasty significantly improved the postoperative function of patients with femoral neck fractures. The surface under the cumulative ranking curve value of the Harris hip score for more than 1 year after total hip arthroplasty was 98.2. Conclusions This meta-analysis indicated no significant difference in mortality among different treatment groups. Total hip arthroplasty can provide satisfactory outcomes in hip joint function, and double-screw fixation results in the lowest intraoperative risk. In general, total hip arthroplasty results in a lower incidence of adverse events and is especially recommended for patients with femoral neck fractures. This article has been retrospectively registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) on November 27, 2020. Registration number: INPLASY2020110123.

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“…Among them, some patients may achieve satisfactory results as long as they are treated with IF.Their study demonstrates that patients undergoing THA had higher in hospital complication rates and longer length of stay than patients undergoing IF. The in-hospital mortality for patients undergoing a hip hemiarthroplasty(HA) was higher (1.2%) than either THA (0.2%) or IF (0.5%).Two studies of nondisplaced FNF patients over the age of 70 found that among patients receiving IF and the arthroplasty, patients treated with arthroplasty had higher 30-days mortality rate(11%)( 16) and patients treated with internal xation have a higher 2-year mortality rate(36%) (17).Several studies have shown that IF may be more cost-effective than hip arthroplasty because the total cost is less (15,18,19).Lagergrenet et al (20)reported that HA with baseline results in patient reported outcome measure indicating poorer health and function, as well as higher mortality and lower response rates with patients aged 60-69.IF tend to fail in up to 1/3 of the cases but can offer the bene ts of a biologically intact hip if successful.In young elderly people, it is still worth for doctors to choose IF to preserve the native hip joint among the appropriate fracture types.…”

Section: Discussionmentioning

confidence: 99%

Distribution Characteristics of New AO Classification in Different Age Groups of Patients with Femoral Neck Fracture

Jiang

Feng

Huang

et al. 2022

Preprint

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Objective: Femoral neck fractures(FNFs) patients from 2018 to 2020 were classified according to the new AO classification. To observe the proportion of new AO classification and provide reference for improving the upper age limit of internal fixation(IF) treatmentMethods: In this study, patients with femoral neck fracture hospitalized in Xi 'an Honghui Hospital from January 2018 to January 2021 were divided into four groups according to age: the young group (≤44 years old), the middle-aged group (45-59 years old),the young elderly group (60-74 years old), and the elderly group (≥75 years old) to analyze age,sex,side,injury mechanism,new AO classification and other features . A total of 2071 patients were included for analysis.Results: There were 742 males (35.8%) and 1,329 females (64.2%).There were 1,106 patient s(53.4%) on the left side and 965 on the right side (46.6%).There were 1781 patients of low energy injury (86%) and 290 patients of high energy injury (14%), and the main injury mechanism was falling.The number of patients with femoral neck fracture in each year was 719 patients in 2018, 694 patients in 2019, and 661 patients in 2020, respectively. The number of patients showed a decreasing trend year by year, and the gender ratio and injury mechanism showed no significant trend of change. In the age group, the proportion of the young group was increasing year by year.Among the new AO classification, there were 1023 patients of B1.3, accounting for the highest proportion of 49.4%.The proportion of B2.2 was the highest in the young group (32.4%) .B1.3 and B2.2 were the main types in the middle-aged group, accounting for 31.7% and 32.0, respectively.B1.3 was dominant in the young elderly and elderly group (47.1% and 63.4%, respectively).Conclusion: The new AO classification is more detailed and practical. 1/3 of the fracture types of middle aged and young elderly people may achieve satisfactory results through IF.Level of evidence: III.

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Displaced femoral neck fractures in patients 60-69 years old – treatment and patient reported outcomes in a register cohort

Cited by 11 publications

References 27 publications

The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register

The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register

Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review

Distribution Characteristics of New AO Classification in Different Age Groups of Patients with Femoral Neck Fracture

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