The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study
Abstract Background Hip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03981-5 |
| _version_ | 1797778792236711936 |
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| author | Yannick Rau Jasper Amtsfeld Nils Reimers Ludwig Matrisch Jasper Frese Arndt-Peter Schulz |
| author_facet | Yannick Rau Jasper Amtsfeld Nils Reimers Ludwig Matrisch Jasper Frese Arndt-Peter Schulz |
| author_sort | Yannick Rau |
| collection | DOAJ |
| description | Abstract Background Hip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments. Methods Data were retrieved from the national database of the German Department of the Interior. ICD-10-GM and OPS data from the period of 2006 to 2020 were analysed and all patients with trochanteric and subtrochanteric fractures as their main diagnosis, who were treated in a German hospital, were included. Patients were grouped by age and gender and linear regression was performed where suitable to calculate statistically significant correlations between variables and incidences. Results 985,104 pertrochanteric fractures and 178,810 subtrochanteric fractures were reported during the analysed period. We calculated a mean incidence of 80.08 ± 6.34 for pertrochanteric and 14.53 ± 1.50 for subtrochanteric fractures per million inhabitants. In both fracture types, a distinct dependence of incidence on age can be determined. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under the age of 60 to those over the age of 90 in pertrochanteric fractures, and about 123-fold in subtrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Plate and dynamic compression screws were decreasing in frequency over the analysed period in both fractures. Conclusions We provided incidence data on per- and subtrochanteric fractures and their treatment. We calculated an economic impact of approximately 1.563 billion € per year in Germany. With regards to recent literature on costs of treatment and our findings regarding the implementation and utilization of different treatment methods, we conclude that the reinforcement of nationwide prevention programs is a relevant step in lessening the economic burden. We welcome the increased utilisation of intramedullary nailing as many studies show beneficiary outcomes and cost effectiveness in most of the included fracture types. |
| first_indexed | 2024-03-12T23:22:40Z |
| format | Article |
| id | doaj.art-cdc6bda1ab234dfc9debedc19304292b |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-12T23:22:40Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-cdc6bda1ab234dfc9debedc19304292b2023-07-16T11:22:59ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-07-0118111210.1186/s13018-023-03981-5The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort studyYannick Rau0Jasper Amtsfeld1Nils Reimers2Ludwig Matrisch3Jasper Frese4Arndt-Peter Schulz5Faculty of Medicine, Universität zu LübeckChair of Technology Management, Christian-Albrechts-Universität zu KielStryker Trauma GmbHFaculty of Medicine, Universität zu LübeckZentrum Klinische Forschung, BG Klinikum HamburgFaculty of Medicine, Universität zu LübeckAbstract Background Hip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments. Methods Data were retrieved from the national database of the German Department of the Interior. ICD-10-GM and OPS data from the period of 2006 to 2020 were analysed and all patients with trochanteric and subtrochanteric fractures as their main diagnosis, who were treated in a German hospital, were included. Patients were grouped by age and gender and linear regression was performed where suitable to calculate statistically significant correlations between variables and incidences. Results 985,104 pertrochanteric fractures and 178,810 subtrochanteric fractures were reported during the analysed period. We calculated a mean incidence of 80.08 ± 6.34 for pertrochanteric and 14.53 ± 1.50 for subtrochanteric fractures per million inhabitants. In both fracture types, a distinct dependence of incidence on age can be determined. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under the age of 60 to those over the age of 90 in pertrochanteric fractures, and about 123-fold in subtrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Plate and dynamic compression screws were decreasing in frequency over the analysed period in both fractures. Conclusions We provided incidence data on per- and subtrochanteric fractures and their treatment. We calculated an economic impact of approximately 1.563 billion € per year in Germany. With regards to recent literature on costs of treatment and our findings regarding the implementation and utilization of different treatment methods, we conclude that the reinforcement of nationwide prevention programs is a relevant step in lessening the economic burden. We welcome the increased utilisation of intramedullary nailing as many studies show beneficiary outcomes and cost effectiveness in most of the included fracture types.https://doi.org/10.1186/s13018-023-03981-5Trochanteric fracturesTraumaOsteosynthesisEpidemiologyIncidence |
| spellingShingle | Yannick Rau Jasper Amtsfeld Nils Reimers Ludwig Matrisch Jasper Frese Arndt-Peter Schulz The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study Journal of Orthopaedic Surgery and Research Trochanteric fractures Trauma Osteosynthesis Epidemiology Incidence |
| title | The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study |
| title_full | The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study |
| title_fullStr | The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study |
| title_full_unstemmed | The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study |
| title_short | The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study |
| title_sort | development incidence and treatment trends of trochanteric fractures in germany a cohort study |
| topic | Trochanteric fractures Trauma Osteosynthesis Epidemiology Incidence |
| url | https://doi.org/10.1186/s13018-023-03981-5 |
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