Reoperation rate, mortality and ambulatory ability after internal fixation versus hemiarthroplasty for unstable intertrochanteric fractures in elderly patients: a study on Korean Hip Fracture Registry

2020 ◽  
Vol 140 (11) ◽  
pp. 1611-1618 ◽  
Author(s):  
Jin-Woo Kim ◽  
Hyun-Chul Shon ◽  
Sang-Heon Song ◽  
Young-Kyun Lee ◽  
Kyung-Hoi Koo ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Reoperation Rate ◽  
Intertrochanteric Fractures ◽  
Ambulatory Ability

scholarly journals Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Hsuan-Hsiao Ma ◽  
Te-Feng Arthur Chou ◽  
Shang-Wen Tsai ◽  
Cheng-Fong Chen ◽  
Po-Kuei Wu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Femoral Neck Fracture ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Reoperation Rate ◽  
Fixation Group ◽  
Neck Fracture

Abstract Background Although internal fixation has been the main treatment option for elderly patients with an undisplaced femoral neck fracture, it is associated with a high reoperation rate. Some surgeons have discussed the use of hemiarthroplasty, but there is limited literature comparing these two treatment modalities. In this study, we compared the perioperative results of hemiarthroplasty with internal fixation for undisplaced femoral neck fractures. Methods We performed a comprehensive review of literatures on PubMed, Web of Science, Embase, and the Cochrane Library for randomized controlled trials and comparative observational studies. Of the 441 studies initially identified, 3 met all inclusion criteria. Two reviewers independently graded study quality and abstracted relevant data including reoperation rate, mortality rate, Harris Hip Score (HHS), length of hospital stay, and operation duration. Results Our results revealed that hemiarthroplasty was associated with a lower reoperation rate than the internal fixation group (OR 4.489; 95% CI 2.030 to 9.927). Mortality rate at postoperative 1 month and 1 year and HHS at postoperative 1 year and 2 years were not different. Length of hospital stay (SMD − 0.800, 95% CI − 1.011 to − 0.589) and operation duration (SMD − 2.497, 95% CI − 2.801 to − 2.193) were shorter in the internal fixation group. Conclusions Compared with the internal fixation group, patients that underwent hemiarthroplasty had a lower reoperation rate and an equivalent overall mortality rate. Our meta-analysis suggests that hemiarthroplasty might be a better treatment choice than internal fixation in treating elderly patients with an undisplaced femoral neck fracture.

Outcomes of nondisplaced intracapsular femoral neck fractures with internal screw fixation in elderly patients: a systematic review

2017 ◽  
Vol 28 (1) ◽  
pp. 18-28 ◽  
Author(s):  
Ignacio J. Oñativia ◽  
Pablo A.I. Slulittel ◽  
Fernando Diaz Dilernia ◽  
Juan M. Gonzales Viezcas ◽  
Valeria Vietto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
The Elderly ◽  
Reoperation Rate ◽  
Femoral Neck Fractures ◽  
Displaced Femoral Neck Fractures

Introduction: Although the preferred treatment for displaced femoral neck fractures in the elderly is hip arthroplasty, the treatment for impacted or undisplaced femoral neck fractures (UFNF) is still a subject of controversy. Our purpose was to systematically review studies of elderly patients with UFNF treated with internal fixation using screws: (i) what is the reported mortality; (ii) what is the reoperation rate; (iii) what are the clinical and radiological outcomes; and (iv) what is the methodological quality of the included studies? Methods: This systematic review was performed through a search of PubMed and the Cochrane database using a structured search algorithm including studies enrolling patients older than 60 years old, with UFNF treated with internal fixation using screws. Our literature search returned 950 studies and 11 were selected for final abstraction. Results: 6 studies reported mortality rate. At 1-year follow-up mortality was reported by 3 studies: 18.8%; 22%, and 19%. At 5 years, 1 study reported mortality rate of 42%. Overall reoperation rate was reported by 9 studies and ranged from 8%-19%, while conversion to hip arthroplasty was performed in the range between 8% and 16% according to 6 studies. Conclusions: Internal fixation with cannulated screws for UFNF in the elderly is a valuable option, although it has substantial reoperation and mortality rates. Further prospective high-quality, randomised controlled trials are required to establish the optimal approach for the treatment of UFNF.

Bipolar hemiarthroplasty compared with internal fixation for unstable intertrochanteric fractures in elderly patients

2012 ◽  
Vol 17 (6) ◽  
pp. 722-729 ◽  
Author(s):  
Jun Shen ◽  
Dong-Lai Wang ◽  
Guang-Xiang Chen ◽  
Li Li ◽  
Min-Xiang Wei ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Internal Fixation ◽  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures

scholarly journals Does short-term weekly teriparatide improve healing in unstable intertrochanteric fractures?

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880248 ◽  
Author(s):  
Seung-Ju Kim ◽  
Hyun-Soo Park ◽  
Dong-Woo Lee ◽  
Jae-Won Lee
Keyword(s):  
Hip Fracture ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Intertrochanteric Fracture ◽  
Long Term Results ◽  
Complication Rates ◽  
Intertrochanteric Fractures ◽  
Short Term ◽  
Group 2 ◽  
Group 1

Slow recovery after hip fracture has been associated with negative consequences. Thus, there is medical need to improve healing and functional recovery after intertrochanteric fracture. The aim of this study was to measure whether short-term teriparatide would improve healing in intertrochanteric fractures after internal fixation as measured by (1) clinical scores, (2) radiographic fracture healing, and (3) complication rates. We retrospectively reviewed 96 patients (average age, 82 years) who underwent closed reduction and internal fixation with proximal femoral nail (PFN) for unstable intertrochanteric fractures between 2014 and 2016. Of the 96 patients, 56 patients were treated with a PFN alone (group 1). These patients were compared with 46 patients for whom the same device was used and a weekly subcutaneous injection of PTH 1-34 (teriparatide) was prescribed postoperatively (group 2). Questionnaire surveys or telephone interviews were conducted, and patients completed a self-report Harris hip score and visual analog scale scores. The radiological time to fracture healing was assessed as the primary end point. Postoperative complication rates were compared. Functional outcomes at 6 months after surgery were similar in both groups. There were no differences between groups in the proportion of patients achieving radiographic fracture healing. The frequency of patients reporting adverse events was 20% (10 of 50) in group 1 versus 17% (8 of 46) in group 2 ( p = 0.744). Short-term teriparatide did not improve radiographic signs of fracture healing of an intertrochanteric fracture and reduce the incidence of complications. The effect of teriparatide on fracture healing remains uncertain. Further multicenter prospective studies are needed to demonstrate objective long-term results of parathyroid hormone therapy in patient with hip fracture. Level of Evidence: Level IV, therapeutic study.

Internal fixation of intracapsular femoral neck fractures in elderly patients: mortality and reoperation rate

2019 ◽  
Vol 32 (6) ◽  
pp. 1173-1178
Author(s):  
Marco Bigoni ◽  
Marco Turati ◽  
Giulio Leone ◽  
Agostino Dario Caminita ◽  
Fabio D’Angelo ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Reoperation Rate ◽  
Femoral Neck Fractures

scholarly journals X-Ray Film under Artificial Intelligence Algorithm in the Evaluation for Nursing Effect of Gamma Nail Internal Fixation in Elderly Patients with Intertrochanteric Fracture of Femur

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yudi Wang ◽  
Xin Wang ◽  
Lei Jin ◽  
Xuemei Wei
Keyword(s):  
Artificial Intelligence ◽  
Elderly Patients ◽  
Internal Fixation ◽  
Intertrochanteric Fracture ◽  
Gamma Nail ◽  
Control Group ◽  
Intertrochanteric Fractures ◽  
X Ray ◽  
Intelligence Algorithm ◽  
Artificial Intelligence Algorithm

The aim of this work was to explore the effects of Gamma nail internal fixation for intertrochanteric fracture of femur by X-ray film classification and recognition method based on artificial intelligence algorithm. The study subjects were 100 elderly patients with intertrochanteric fracture of femur admitted to hospital. The cases were diagnosed as elderly (over 60 years old) femoral intertrochanteric fractures by X-ray or CT. They were divided into two groups, with 50 persons in each group: one group used the X-ray film evaluation image guidance based on the artificial intelligence algorithm (research group), and the other group did not use algorithmic guidance (control group). The results showed that the segmentation effect of the proposed algorithm was similar to the gold standard segmentation result, indicating that the algorithm was effective and feasible in the segmentation of fractures and bones. The global level set algorithm was set as the control. The ultimate measurement accuracy (UMA) value of the algorithm group was ( 1.77 ± 0.22 ), and the UMA value of the global level set algorithm group was ( 3.42 ± 0.36 ), indicating that the image processed by the algorithm group had obvious numerical effect, high accuracy, and good retention of details. The operation time, intraoperative blood loss, incision length, hospital stay, weight-bearing time, and fracture healing time of the two groups were all better than those of the control group. One month after surgery, the Harris score of the algorithm group was 67, and that of the control group was 51, with a 16-point difference between the two groups ( p < 0.05 ). The patient had less pain and fast recovery speed, indicating that it was a good way to treat elderly intertrochanteric fractures with the nursing effect of X-ray Gamma nail internal fixation based on an artificial intelligence algorithm. The artificial intelligence algorithm not only can be applied to the Gamma nail internal fixation of elderly patients with intertrochanteric fractures but also can be applied to the X-ray image processing of other fractures and other surgical methods to provide effective treatment for fracture patients.

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