Total hip arthroplasty for femoral neck fractures as an urgent procedure

Background/Aim. Total hip arthroplasty (THA) is one of the most widely accepted operative methods for femoral neck fracture (FNF) in elderly. However, the data on the early THA for FNF are very limited. The aim of this study to determine if there were differences in postoperative complications and f...

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Main Authors: Radoičić Dragan, Dašić Žarko, Mitković Milorad, Starčević Srđan
Format: Article
Language:English
Published: Military Health Department, Ministry of Defance, Serbia 2017-01-01
Series:Vojnosanitetski Pregled
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600230R.pdf
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author Radoičić Dragan
Dašić Žarko
Mitković Milorad
Starčević Srđan
author_facet Radoičić Dragan
Dašić Žarko
Mitković Milorad
Starčević Srđan
author_sort Radoičić Dragan
collection DOAJ
description Background/Aim. Total hip arthroplasty (THA) is one of the most widely accepted operative methods for femoral neck fracture (FNF) in elderly. However, the data on the early THA for FNF are very limited. The aim of this study to determine if there were differences in postoperative complications and functional outcomes between an urgent and delayed THA following FNF. Methods. This prospective study included a total of 244 patients who had THA following FNF from January 2010 to January 2013. In the first group 41 FNF patients were treated with THA within less than 12 hours of admission. A total of 203 FNF patients were operated in delayed settings, of whom 162 required prolonged preoperative processing and comorbidities correction. The group II consisted of 41 FNF patients who were fit for the early surgery at admission, but the operation was delayed due to institution related reasons. Main outcome measurements included mortality, functional outcome assessement, cardiological and pulmonary complications, pressure ulcers, dislocations, infections, length of hospitalization and revisions. Results. There were no differences in terms of age, gender, type of implants, neither in mortality, nor complications. There were differences in hospital length of stay [t (51.72) = -10.25, p < 0.001)]. The patients operated within less than 12 hours of admission, had significantly better scores at all three time points of functional outcome assessment: at discharge t (80) = 2.556, p < 0.012; one month t (80) = 4.731, p < 0.001; three months t (80) = 5.908, p < 0.001. Conclusion. THA for FNF as an urgent procedure is not a widely accepted concept. Our findings indicate that the early operative treatment, does not worsen clinical outcomes, and our results give an advantage to the policy of the early THA for FNF.
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spelling doaj.art-2ccedb085ad84010b449295d1b4377f72022-12-22T03:09:10ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202017-01-0174545045510.2298/VSP150826230R0042-84501600230RTotal hip arthroplasty for femoral neck fractures as an urgent procedureRadoičić Dragan0Dašić Žarko1Mitković Milorad2Starčević Srđan3Clinic for Orthopedic Surgery and Traumatology, Military Medical Academy, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeClinical Center of Montenegro, Orthopedic and Traumatology Clinic, Podgorica, Montenegro + University of Montenegro, Faculty of Medicine, Podgorica, MontenegroClinical Center Niš, Orthopedic and Traumatology Clinic, Niš + Faculty of Medicine, NišClinic for Orthopedic Surgery and Traumatology, Military Medical Academy, Belgrade + University of Defence, Faculty of Medicine of the Military Medical Academy, BelgradeBackground/Aim. Total hip arthroplasty (THA) is one of the most widely accepted operative methods for femoral neck fracture (FNF) in elderly. However, the data on the early THA for FNF are very limited. The aim of this study to determine if there were differences in postoperative complications and functional outcomes between an urgent and delayed THA following FNF. Methods. This prospective study included a total of 244 patients who had THA following FNF from January 2010 to January 2013. In the first group 41 FNF patients were treated with THA within less than 12 hours of admission. A total of 203 FNF patients were operated in delayed settings, of whom 162 required prolonged preoperative processing and comorbidities correction. The group II consisted of 41 FNF patients who were fit for the early surgery at admission, but the operation was delayed due to institution related reasons. Main outcome measurements included mortality, functional outcome assessement, cardiological and pulmonary complications, pressure ulcers, dislocations, infections, length of hospitalization and revisions. Results. There were no differences in terms of age, gender, type of implants, neither in mortality, nor complications. There were differences in hospital length of stay [t (51.72) = -10.25, p < 0.001)]. The patients operated within less than 12 hours of admission, had significantly better scores at all three time points of functional outcome assessment: at discharge t (80) = 2.556, p < 0.012; one month t (80) = 4.731, p < 0.001; three months t (80) = 5.908, p < 0.001. Conclusion. THA for FNF as an urgent procedure is not a widely accepted concept. Our findings indicate that the early operative treatment, does not worsen clinical outcomes, and our results give an advantage to the policy of the early THA for FNF.http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600230R.pdffemoral neck fracturesarthroplasty, replacement, hiptime factorstreatment outcomeorthopedic procedures
spellingShingle Radoičić Dragan
Dašić Žarko
Mitković Milorad
Starčević Srđan
Total hip arthroplasty for femoral neck fractures as an urgent procedure
Vojnosanitetski Pregled
femoral neck fractures
arthroplasty, replacement, hip
time factors
treatment outcome
orthopedic procedures
title Total hip arthroplasty for femoral neck fractures as an urgent procedure
title_full Total hip arthroplasty for femoral neck fractures as an urgent procedure
title_fullStr Total hip arthroplasty for femoral neck fractures as an urgent procedure
title_full_unstemmed Total hip arthroplasty for femoral neck fractures as an urgent procedure
title_short Total hip arthroplasty for femoral neck fractures as an urgent procedure
title_sort total hip arthroplasty for femoral neck fractures as an urgent procedure
topic femoral neck fractures
arthroplasty, replacement, hip
time factors
treatment outcome
orthopedic procedures
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2017/0042-84501600230R.pdf
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AT dasiczarko totalhiparthroplastyforfemoralneckfracturesasanurgentprocedure
AT mitkovicmilorad totalhiparthroplastyforfemoralneckfracturesasanurgentprocedure
AT starcevicsrđan totalhiparthroplastyforfemoralneckfracturesasanurgentprocedure