Fixation Failure in Femoral Neck Fractures

Estrada, Lance S.; Volgas, David A.; Stannard, James P.; Alonso, Jorge E.

doi:10.1097/00003086-200206000-00013

Cited by 103 publications

(75 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of internal fixation in FNFs has been associated with reoperation rates ranging from 10% to 49% [18,21,22,24,42,44] compared with 0% to 24% for hemiarthroplasty [5,18,36,44], resulting in a more costly treatment strategy than hemiarthroplasty [1,25]. Despite increased complications and technical difficulties associated with salvage of failed fixation [16,23,34], some argue the higher reoperation rate is offset by the benefits of preservation of the native femoral head and avoidance of potential complications associated with arthroplasty [2,13,31]. Mortality at 1 year ranges from 14% to 36% but without differences in mortality between fixation and hemiarthroplasty at 1, 5, and 10 years [8,18,19,31,36,37].…”

Section: Introductionmentioning

confidence: 99%

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

Murphy

Randell

Brennan

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Femoral neck fractures (FNFs) comprise 50% of geriatric hip fractures. Appropriate management requires surgeons to balance potential risks and associated healthcare costs with surgical treatment. Treatment complications can lead to reoperation resulting in increased patient risks and costs. Understanding etiologies of treatment failure and the population at risk may decrease reoperation rates. Questions/purposes We therefore (1) determined if treatment modality and/or displacement affected reoperation rates after FNF; and (2) identified factors associated with increased reoperation and timing and reasons for reoperation. Methods We reviewed 1411 records of patients older than 60 years treated for FNF with internal fixation or hemiarthroplasty between 1998 and 2009. We extracted patient age, sex, fracture classification, treatment modality and date, occurrence of and reasons for reoperation, comorbid conditions at the time of each surgery, and dates of death or last contact. Minimum followup was 12 months (median, 45 months; range, 12-157 months). Results Internal fixation (hazard ratio [HR], 6.38) and displacement (HR, 2.92) were independently associated with increased reoperation rates. The reoperation rate for nondisplaced fractures treated with fixation was 15% and for displaced fractures 38% after fixation and 7% after hemiarthroplasty. Most fractures treated with fixation underwent reoperation within 1 year primarily for nonunion. Most fractures treated with hemiarthroplasty underwent reoperation within 3 months, primarily for infection. Conclusions Overall, hemiarthroplasty resulted in fewer reoperations versus internal fixation and displaced fractures underwent reoperation more than nondisplaced. Our data suggest there are fewer reoperations when treating elderly patients with displaced FNFs with hemiarthroplasty than with internal fixation. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

show abstract

Section: Introductionmentioning

confidence: 99%

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

Murphy

Randell

Brennan

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…However, when compared to THA indicated for osteoarthritis, THA indicated for trauma is associated with a higher percentage of complications [22,[25][26][27][30][31][32][33]. Similar to others, we feel that the higher the mean age of patients, the worse the general condition, and a poorer quality of the muscle tissue contributes to a higher incidence of postoperative complications after THA for a fracture of the femoral neck [10,20,30,34].…”

mentioning

confidence: 68%

“…Absence of sclerotic subchondral bone in the acetabular region, evident in degenerated hip and poorer quality of the bone (osteoporosis) in older patients, worsen the conditions for long-term fixation of components in contrast to the situation in patients undergoing THA due to degenerative changes of the hip [3,10,[25][26][27]33,46,47].…”

Section: Clinical Outcomes -Hhsmentioning

confidence: 99%

“…However, some authors point out that the rate of complications in the early postoperative period and failures of the arthroplasty later due to loosening of individual components is higher when compared to the rate of complications following THA for osteoarthritis [10][11][12][13]. The purpose of this study was to determine the medium-term functional and radiographic outcomes in patients who had undergone primary THA for displaced intracapsular fractures of the femoral neck, and to discuss if our results sufficiently support the primary indication of THA for displaced intracapsular fractures of the femoral neck.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Primary total hip arthroplasty for displaced intracapsular fracture of the femoral neck: Medium-term functional and radiographic outcomes

et al. 2008

View full text Add to dashboard Cite

AbstractThe number of complications after primary total hip arthroplasty for displaced intracapsular fractures of the femoral neck is higher than that after operations for osteoarthritis. The aim of this study is to evaluate the number of complications and mid-term functional and radiological findings of patients after primary THA for displaced intracapsular fractures of the femoral neck. Between 1995 and 1998, we operated on a total of 89 patients for acute displaced intracapsular fractures of the femoral neck, i.e. Garden Type 3 and 4. In all the patients we evaluated intraoperative and early postoperative complications. We reviewed clinical and radiological results in 65 patients. The only intraoperative complication was abruption of the greater trochanter. Early postoperative complications occurred in 13 patients (15%). The specific complications, THA dislocation, occurred in 3 patients. Non-specific complications were recorded in 10 patients. No delayed healing of the surgical wound, neural lesion or early, delayed or late infection was recorded. Of 65 patients followed-up for an average of 78 months (range, 62–109 months), 8 patients underwent revision surgery. Of 57 patients with primary THA, very good and good clinical results according to the Harris Hip Score were recorded in 48 patients (84%) and poor results in only 2 patients (4%). Nine of 57 followed-up patients showed radiological signs of loosening (16%). The radiolucent line could be seen in 3 patients in the region of the cup, in 1 patient in the region of the femoral component and in 5 patients in both components. Clinical complaints that would result in indication for reimplantation were recorded in none of the mentioned patients. Number of complications, functional results and resumption of full self-reliance by patients after THA for an intracapsular fracture of the femoral neck are so positive that we consider the indication of THA for a displaced femoral neck fracture fully justified.

show abstract

“…Prosthetic replacement generally is the preferred treatment for patients older than 60 years [10,13,21], and salvage of the femoral head has been advocated for younger patients [10,14,21,27]. With increasing life expectancy of patients with prostheses, late complications of prosthetic replacement are increasing [6,21]. Numerous procedures have been described for salvaging the femoral head to avoid or delay hip replacement in patients younger than 60 years.…”

Section: Introductionmentioning

confidence: 99%

Modified Pauwels’ Intertrochanteric Osteotomy in Neglected Femoral Neck Fracture

Magu

Rohilla

Singh

et al. 2009

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

Fixation Failure in Femoral Neck Fractures

Cited by 103 publications

References 25 publications

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

Treatment and Displacement Affect the Reoperation Rate for Femoral Neck Fracture

Primary total hip arthroplasty for displaced intracapsular fracture of the femoral neck: Medium-term functional and radiographic outcomes

Modified Pauwels’ Intertrochanteric Osteotomy in Neglected Femoral Neck Fracture

Contact Info

Product

Resources

About