In-hospital mortality risk of intertrochanteric hip fractures: a comprehensive review of the US Medicare database from 2005 to 2010

Kiriakopoulos, Emmanouil; McCormick, Frank; Nwachukwu, Benedict U.; Erickson, Brandon J.; Caravella, Joseph

doi:10.1007/s12306-017-0470-3

Cited by 18 publications

(20 citation statements)

References 16 publications

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“…ITFs are known to cause more complications (such as pneumonia and anemia) and postoperative mortality than femoral neck fractures [3]. Thus, reducing mortality and morbidity rates after ITF surgery, with an emphasis on improving perioperative care, is important for increasing the overall survival [4].…”

Section: Introductionmentioning

confidence: 99%

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Lin

Chien

Hung

et al. 2020

BMC Musculoskelet Disord

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Background: With an increase in the elderly population, the occurrence of hip fractures, femoral neck fractures, and intertrochanteric fractures (ITFs) is also increasing. It is important to establish effective perioperative methods that would help reduce the morbidity and mortality rates associated with ITFs. The purpose of this study was to determine the effects of ITFs according to the AO classification for perioperative hemoglobin drop. Methods: Seventy-six patients with ITFs classified as AO 31-A1 or A2 and fixated with intramedullary nails participated in this retrospective cohort study. Medical records of these patients were retrospectively reviewed from September 2016 to August 2018. The perioperative hemoglobin drop was chosen as the main outcome measure and calculated as the difference between pre-and postoperative hemoglobin levels. Multivariate linear regression analysis was performed and included the following variables: AO classification (A1.1-A2.1 [stable] vs. A2.2-A2.3 [unstable]), time interval between injury and surgery, age, body mass index, and the use of anticoagulants. Results: Among the 76 patients who met the inclusion criteria, a significantly higher hemoglobin drop was observed in the AO 31 A2.2-A2.3 (unstable) group than in the AO 31 A1.1-A2.1 (stable) group (p = 0.04). The multivariate analysis also showed a greater hemoglobin drop in the unstable group (p < 0.05). Conclusions: Patients with unstable ITFs exhibited a greater hemoglobin drop and a hidden blood loss was suspected around the fracture site. We believe that this should be taken into consideration when presurgical blood transfusion is being planned for patients with unstable ITFs, to reduce associated postoperative complications, especially in patients with severe anemia or high risk of mortality.

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Section: Introductionmentioning

confidence: 99%

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Lin

Chien

Hung

et al. 2020

BMC Musculoskelet Disord

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“…Intertrochanteric (IT) fractures are common, accounting for almost half of all hip fractures and resulting in a great burden on orthopedic services [1][2][3]. Although most IT fractures can be treated successfully with contemporary surgical techniques and internal fixations such as intramedullary nails and sliding hip screws, clinical failures still occasionally occur, with reported data indicating a range from 0.5 to 56% depending on the fracture type, patient status, and quality of the reduction and fixation [4][5][6][7][8][9]. Failed treatment of IT fractures leads to remarkable disability and pain, which may cause complications associated with prolonged recumbency and affect the vital prognosis of these fragile patients, thereby necessitating effective surgical intervention [10].…”

Section: Introductionmentioning

confidence: 99%

Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art

Liu

Jin

Zhang

et al. 2020

BMC Musculoskelet Disord

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Failed treatment of intertrochanteric (IT) femoral fractures leads to remarkable disability and pain, and revision surgery is frequently accompanied by higher complication and reoperation rates than primary internal fixation or primary hip arthroplasty. There is an urgent need to establish a profound strategy for the effective surgical management of these fragile patients. Salvage options are determined according to patient physiological age, functional level, life expectancy, nonunion anatomical site, fracture pattern, remaining bone quality, bone stock, and hip joint competency. In physiologically young patients, care should be taken to preserve the vitality of the femoral head with salvage internal fixation; however, for the elderly population, conversion arthroplasty can result in early weight bearing and ambulation and eliminates the risks of delayed fracture healing. Technical challenges include a difficult surgical exposure, removal of broken implants, deformity correction, critical bone defects, poor bone quality, high perioperative fracture risk, and prolonged immobilization. Overall, the salvage of failed internal fixations of IT fractures with properly selected implants and profound techniques can lead to the formulation of valuable surgical strategies and provide patients with satisfactory clinical outcomes.

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“…ITFs are known to cause a more complications(such as pneumonia and anemia) and postoperative mortality than femoral neck fractures. Thus, reducing mortality and morbidity rates after ITF surgery, with an emphasis on improving perioperative care, is important for increasing overall survival (3).…”

Section: Introductionmentioning

confidence: 99%

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Lin

Chien

Hung

et al. 2019

Preprint

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In-hospital mortality risk of intertrochanteric hip fractures: a comprehensive review of the US Medicare database from 2005 to 2010

Cited by 18 publications

References 16 publications

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

Revision surgery due to failed internal fixation of intertrochanteric femoral fracture: current state-of-the-art

Unstable intertrochanteric fractures are associated with a greater hemoglobin drop during the perioperative period: a retrospective case control study

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