Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors
Aim Internal fixation of femoral neck fractures is a widely used procedure that is comparatively less invasive and faster than hip replacement. While head preserving internal fixation of these fractures are still preferred where feasible, a faster recovery and lower reoperation rates make arthroplas...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-03-01
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| Series: | Geriatric Orthopaedic Surgery & Rehabilitation |
| Online Access: | https://doi.org/10.1177/21514593231164105 |
| _version_ | 1811154654040424448 |
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| author | Viktor Labmayr MD Andrea Borenich MSc - statistician Thomas Pusch MD Patrick Reinbacher MD Georg Hauer MD Patrick Sadoghi MD, Prof Andreas Leithner MD, Prof Andrea Berghold Prof - statistician Paul Puchwein MD, Prof |
| author_facet | Viktor Labmayr MD Andrea Borenich MSc - statistician Thomas Pusch MD Patrick Reinbacher MD Georg Hauer MD Patrick Sadoghi MD, Prof Andreas Leithner MD, Prof Andrea Berghold Prof - statistician Paul Puchwein MD, Prof |
| author_sort | Viktor Labmayr MD |
| collection | DOAJ |
| description | Aim Internal fixation of femoral neck fractures is a widely used procedure that is comparatively less invasive and faster than hip replacement. While head preserving internal fixation of these fractures are still preferred where feasible, a faster recovery and lower reoperation rates make arthroplasty increasingly more appealing, in spite of being a more invasive option. Our aim was to determine the reoperation rate after internal fixation at our institution and to explore relevant risk factors in a geriatric population. Methods This monocentric follow-up study was conducted analyzing 116 patients aged 65 and older with femoral neck fractures who were surgically treated with either cancellous screws or dynamic hip screws between 2010 and 2017. We retrospectively collected longitudinal data from our patient database, supplemented by a telephone survey, with a follow-up period of at least 18 months. Results Twenty reoperations, due to either a failure of fixation, avascular necrosis, or posttraumatic osteoarthritis, were identified in our cohort, which constituted a reoperation rate of 17.2% (20/116). Fracture displacement was significantly associated with the reoperation risk (HR 8, CI 3-20; P < .001). The reoperation rate was 52.2% in displaced fractures vs 8.9% in undisplaced fractures. No link was found between the reoperation rate and gender, age, BMI, ASA score, type of implant, quality of internal fixation, type of living accommodation, and pre-fracture mobility. Conclusion Internal fixation has been found to be an effective option in elderly patients with undisplaced fractures regardless of their specific age, cognitive ability or physical condition. In displaced fractures the reoperation rate was found to be high, therefore a primary hip replacement should be recommended. |
| first_indexed | 2024-04-10T04:19:40Z |
| format | Article |
| id | doaj.art-7c74b5a3f61640888ae9a25872a1f42b |
| institution | Directory Open Access Journal |
| issn | 2151-4593 |
| language | English |
| last_indexed | 2024-04-10T04:19:40Z |
| publishDate | 2023-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Geriatric Orthopaedic Surgery & Rehabilitation |
| spelling | doaj.art-7c74b5a3f61640888ae9a25872a1f42b2023-03-11T09:03:32ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932023-03-011410.1177/21514593231164105Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk FactorsViktor Labmayr MDAndrea Borenich MSc - statisticianThomas Pusch MDPatrick Reinbacher MDGeorg Hauer MDPatrick Sadoghi MD, ProfAndreas Leithner MD, ProfAndrea Berghold Prof - statisticianPaul Puchwein MD, ProfAim Internal fixation of femoral neck fractures is a widely used procedure that is comparatively less invasive and faster than hip replacement. While head preserving internal fixation of these fractures are still preferred where feasible, a faster recovery and lower reoperation rates make arthroplasty increasingly more appealing, in spite of being a more invasive option. Our aim was to determine the reoperation rate after internal fixation at our institution and to explore relevant risk factors in a geriatric population. Methods This monocentric follow-up study was conducted analyzing 116 patients aged 65 and older with femoral neck fractures who were surgically treated with either cancellous screws or dynamic hip screws between 2010 and 2017. We retrospectively collected longitudinal data from our patient database, supplemented by a telephone survey, with a follow-up period of at least 18 months. Results Twenty reoperations, due to either a failure of fixation, avascular necrosis, or posttraumatic osteoarthritis, were identified in our cohort, which constituted a reoperation rate of 17.2% (20/116). Fracture displacement was significantly associated with the reoperation risk (HR 8, CI 3-20; P < .001). The reoperation rate was 52.2% in displaced fractures vs 8.9% in undisplaced fractures. No link was found between the reoperation rate and gender, age, BMI, ASA score, type of implant, quality of internal fixation, type of living accommodation, and pre-fracture mobility. Conclusion Internal fixation has been found to be an effective option in elderly patients with undisplaced fractures regardless of their specific age, cognitive ability or physical condition. In displaced fractures the reoperation rate was found to be high, therefore a primary hip replacement should be recommended.https://doi.org/10.1177/21514593231164105 |
| spellingShingle | Viktor Labmayr MD Andrea Borenich MSc - statistician Thomas Pusch MD Patrick Reinbacher MD Georg Hauer MD Patrick Sadoghi MD, Prof Andreas Leithner MD, Prof Andrea Berghold Prof - statistician Paul Puchwein MD, Prof Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors Geriatric Orthopaedic Surgery & Rehabilitation |
| title | Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors |
| title_full | Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors |
| title_fullStr | Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors |
| title_full_unstemmed | Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors |
| title_short | Reoperation Rate of Internal Fixation for Femoral Neck Fractures in the Elderly – A Retrospective Follow-Up Study in 116 Patients With an Exploration of Risk Factors |
| title_sort | reoperation rate of internal fixation for femoral neck fractures in the elderly a retrospective follow up study in 116 patients with an exploration of risk factors |
| url | https://doi.org/10.1177/21514593231164105 |
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