Komplikationen bei pertrochantären Frakturen

Füchtmeier, Bernd; Gebhard, Florian; Lenich, Andreas

doi:10.1007/s00113-011-1974-1

Cited by 17 publications

(8 citation statements)

References 25 publications

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“…Infections were a rare complication (2.8%) and comparable to those rates previously reported (1.5%–3.8%). A “collapse of osteosynthesis,” which the literature suggests can be expected in 3.4%–7.7% of patients, was seen in 3.9% of our study patients.…”

Section: Discussionsupporting

confidence: 47%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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ObjectiveInvestigation of the treatment of femur fractures and the type of femur fracture‐associated complications regarding timing of surgery and length of hospital stay.MethodsIn this retrospective cohort study, a total of 358 hip fractures were evaluated retrospectively from 1 January 2008 until 31 December 2010 at a level I trauma center in Germany. Inclusion criteria was age >18 years and a proximal femur fracture. Both sexes were evaluated. Mean age was 75.5 years, most patients were female (63.7%). Intervention was the operative treatment of proximal femur fracture. Outcome parameters were time until surgery, complications, reoperations, mortality, and length of hospital stay.ResultsAmong the proximal femur fractures (n = 358), 46.6% were pertrochanteric, 11.2% subtrochanteric, and 42.2% femoral neck fractures. Operation upon hip fractures was managed regularly within 24 hours of injury (73%; mean for femoral neck: 28.3 hrs.; mean for pertrochanteric fractures: 21.4 hrs.; mean for subtrochanteric fractures: 19.5 hrs.). Delayed treatment, as well as implantation of hip total endoprosthesis (TEP), increased the overall length of hospital stay (15.4 vs 17.6 days; 18.1 vs 15.8 days). Accordingly, surgical procedures performed within 24 hours of injury resulted in a shorter hospital residence. Longest delay of operation was measured for hip fractures (28.3 hrs.).In 351 patients, secondary injuries were detected in 94 individuals (26%), with fractures being the most common secondary injury (n = 40). We recorded postoperative complications of nonsurgical and surgical origin, and 33.6% of our patient cohort displayed complications. Complications were distributed among 118 patients. There was no significant difference in complications regarding the time of operation, with most nonsurgical and surgical complications appearing within 24 hours after operation (n = 110 vs n = 31). Nonsurgical complications, such as anemia (n = 49) and electrolyte imbalances (n = 30), were observed more frequently than surgical complications (n = 107 vs n = 34); however, these complications were reduced by delay in surgery (82.0% in 6–24 hrs. vs 74.2% in ≥24 hrs.). Anticoagulant therapy and age did not affect postoperative complications. The hospital mortality of patients was 6.2%. Follow‐up was restrained to ambulatory visits in the clinic.ConclusionsSurgical management of hip fractures performed within 24 hours of injury minimizes hospital stay. We did not detect significant differences in the spectrum or number of complications regarding delay of surgery. Surgical complications mainly occur with rapid primary care, and medical complications can be reduced by more intensive preparation of patient and operation procedures.

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Section: Discussionsupporting

confidence: 47%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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“…Proximal femoral fractures are a serious medical and economic problem, the importance of which increases in an ageing population. In the Czech Republic, in persons over 50 years of age they occur in 195.2/100,000 men and 259.4/100,000 woman annually (Vaculik et al 2007); the highest incidence of 1.32% was noted in patients over 85 years of age (Füchtmeier et al 2011). While the available literature offers a sufficient source of classification and treatment options (Bartonicek et al 2002, Bonnaire et al 2011, less attention has been paid to implant failures and their causes (Baumgaertner et al 1995).…”

Section: Introductionmentioning

confidence: 99%

Computational modeling in the prediction of Dynamic Hip Screw failure in proximal femoral fractures

Hrubina¹,

Horák²,

Bartoška³

et al. 2013

JAB

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The aim of the study was to determine the relationship between implant-associated complications andDynamic Hip Screw (DHS) placement in the femoral neck, based on a Finite Element (FE) Analysis. Verydiverse implant failures and subsequent complications can be encountered after introduction of the DHS. Weevaluated 308 dynamic hip screw osteosyntheses for pertrochanteric fractures in 297 patients. The ABAQUS6.9 program was used for development of the FE model, and the analyses were performed in 5 modelledsituations corresponding to five different screw locations. Complications occurred in 10% of patients andre-operation was necessary in 3.9%. The highest risk of implant failure was associated with the screwsituation in the upper third of the femoral neck. Placing a dynamic hip screw in the middle third of the necksignificantly reduced stresses in the plate and screw. The screw position in the upper third of the necksignificantly increased these stresses. The finite element analysis confirmed our clinical experience that theoptimum position of the dynamic hip screw is in the middle third of the femoral neck

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“…Blade cut off, blade migration, nail breakage and locking bolt loosening can be surgeon related technical complications which may be avoided with meticulous planning and execution. The cutout rate has varied in the literature between 2 and 7 % [11][12][13][14] We noted a 1,2 % cutout rate, this suggests that the quality of surgery is acceptable at our institution.…”

Section: Discussionmentioning

confidence: 61%