scholarly journals Low Rates of All-Cause Revision in Displaced Subcapital Femoral Neck Fractures Treated with Hip Hemiarthroplasty - A Retrospective Review of 4516 Patients from a Single Institute

2020 ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Geriatric Population ◽  
Choice Of Treatment ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract Background: Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs.Methods: A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed.Results: In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.Conclusion: HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study

scholarly journals Low Rates of All-Cause Revision in Displaced Subcapital Femoral Neck Fractures Treated with Hip Hemiarthroplasty - A Retrospective Review of 4516 Patients from a Single Institute

2020 ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Geriatric Population ◽  
Choice Of Treatment ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract Background: Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs.Methods: A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed.Results: In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.Conclusion: HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study

scholarly journals Low rates of all-cause revision in displaced subcapital femoral neck fractures treated with hip hemiarthroplasty - a retrospective review of 4516 patients from a single institute

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Geriatric Population ◽  
Choice Of Treatment ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract Background Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs. Methods A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed. Results In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months. Conclusion HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs. Levels of evidence Level III, Retrospective Cohort Study, Therapeutic Study.

scholarly journals Whether Hemiarthroplasty Remains a Gold Standard Treatment for Patients With Displaced Femoral Neck Fractures? - A 20-year Sample of 4516 Patients From a Single Institute

2020 ◽  
Author(s):  
Chi-Yung Yeung ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Cheng-Fong Chen ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Revision Rate ◽  
Femoral Stem ◽  
Recurrent Dislocation ◽  
Geriatric Population ◽  
Displaced Femoral Neck Fractures ◽  
Neck Fracture ◽  
Therapeutic Study

Abstract BackgroundFemoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. This study analysed the causes of HA failure and reevaluated whether HA remains a gold standard treatment for patients with displaced FNFs.MethodsA total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients were enrolled who received the diagnosis of a displaced FNF, underwent primary HA initially, required second revision procedures, and were followed up for a minimum of 36 months. Data were collected and comprehensively analysed.ResultsIn 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.ConclusionHA has an extremely low revision rate and remains a gold standard treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study

Evaluation of the correlation between risk factors and mortality in elderly patients with femoral neck fracture with 5-year follow-up

2008 ◽  
Vol 149 (11) ◽  
pp. 493-503 ◽  
Author(s):  
Andor Sebestyén ◽  
Imre Boncz ◽  
Ferenc Tóth ◽  
Márta Péntek ◽  
József Nyárády ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Femoral Neck Fracture ◽  
Neck Fracture

A csípőtáji törésekhez idős korban magas halálozás társul. A szakirodalomban kevés a nagy beteganyagot feldolgozó, országos kiterjedésű ellátórendszer adatain alapuló feldolgozás. Célkitűzés: A tanulmány célja a 60 év feletti akut, monotraumás combnyaktöröttek primer ellátását követő halálozások vizsgálata havonta és évente ötéves utánkövetéssel, valamint a különböző rizikófaktoraik halálozásra gyakorolt hatásainak értékelése az egyes időperiódusokban. Módszer: Az adatok az Országos Egészségbiztosítási Pénztár adatbázisából származnak. Az értékelés bázisát a fekvőbeteg-ellátást végző intézményekből combnyaktörés primer műtéti ellátását követően 2000. évben emittált betegek képezik. Bemutatjuk az átlagos évenkénti, havonkénti és heti halálozási arányokat, valamint rizikótényezők szerinti alakulásukat havonként és évenként. A rizikótényezők és a halálozás kapcsolatának értékelése logisztikus és Cox-regressziós analízissel történik. Eredmények: A tanulmányban 3783 fő került elemzésre. Átlagéletkoruk 77,97 (SD 8,52) év. A halálozás az első héten 1,71%, 30 napon belül 8,99%, az első évben 30,74%, öt év alatt 61,88% volt. A halálozás havi szinten az első 5 hónapig mutat csökkenést, éves szinten az első év után stagnál. A rizikófaktorok közül a férfinem és a magasabb életkor öt évig, a kísérőbetegségek hatásai a negyedik évig, a laterális combnyaktöréstípus és a 12 órán túli ellátás két évig, a korai lokális szövődmények egy évig, a hétvégi ellátások az első hónapban eredményeznek magasabb halálozási kockázatot. Az országos és egyetemi ellátásokat követően az első évben alacsonyabb a halálozási kockázat. Következtetések: A csípőtáji törések managementjében a halálozások csökkentése érdekében hangsúlyozzuk a 12 órán belüli ellátás, a törési típusnak megfelelő módszerválasztás, a hét minden napján történő azonos ellátási feltételek biztosítása, az ellátások centrumokba történő szervezése, a beteg általános állapotának és kísérőbetegségeinek megfelelő akut ellátás és az utókezelések fontosságát.

scholarly journals A Case Report of Femoral Neck Fracture in an Elderly Patient Managed by Non-operative Korean Medical Treatment : 42 Months Follow-up

2018 ◽  
Vol 35 (4) ◽  
pp. 252-258 ◽  
Author(s):  
Ju-ran Kim ◽  
Han Mi Gong ◽  
Seungah Jun ◽  
Jung Hee Lee ◽  
Bong Hyo Lee ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
Femoral Neck ◽  
Medical Treatment ◽  
Femoral Neck Fracture ◽  
Neck Fracture

scholarly journals Outcome Analysis of Osteosynthesis Versus Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Young Elderly Patient

2021 ◽  
pp. 53-59
Author(s):  
Muhammad Rafique Joyo ◽  
Nizam Ahmed ◽  
Ghazanfar Ali Shah ◽  
Aftab Alam Khanzada ◽  
Tanveer Afzal ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Functional Performance ◽  
Clinical Status ◽  
The Elderly ◽  
Recurrent Dislocation ◽  
Outcome Analysis ◽  
Sudden Increase ◽  
Neck Fracture ◽  
The Mean

This study was designed to compare the osteosynthesis and hemiarthroplasty treatment among the elderly population and evaluate the postoperative functional performance of these two recommended treatments of a displaced femoral neck fracture. Methodology: This retrospective study was conducted in Bone Care trauma center Heerabad  Hospital Hyderabad Pakistan from March 2019 to March 2020. A total of 74 patients of age between  60 to 70 years were selected. All the selected patients were diagnosed with femoral neck fractures (Garden’s III and IV). Harris's hip score was used to evaluate the clinical status of patients with pain, whereas we used Palmer and Parker's mobility to access mobility. Implant breakage, screw cut, and nonunion were considered as parameters of osteosynthesis failure. At the same time, hemiarthroplasty failure was defined as two or more recurrent dislocation, aseptic loosening, periprosthetic fracture, and infection. Results:  In the first three postoperative months, the mean score of the hemiarthroplasty group was reported as 74.44±8.480, which was comparatively high than the osteosynthesis group (66.44±8.520). After six months, this score reached 80.12±7.005 in the hemiarthroplasty group and reached its maximum of 92.14±7.125. After the first three months, the increment ratio was relatively slow with six ratios, but in the last visit, we observed a sudden increase in score in both groups. Regarding Palmer and Parker's mobility score, the hemiarthroplasty group reflected better outcomes than the osteosynthesis group. Conclusion: Our study concluded that management of displaced femoral neck fracture with osteosynthesis revealed a high probability of nonunion, screw cutout complications and enhanced the risk of reoperation. Patients treated with osteosynthesis showed delay rehabilitation.

Comparative Analysis of Preoperative and Postoperative Muscle Around Hip Joint by Computed Tomography Between Intertrochanteric Fracture and Femur Neck Fracture

2020 ◽  
Author(s):  
Sung Yoon Jung ◽  
Hyeon Jun Kim ◽  
Kyu Taek Oh
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Intertrochanteric Fracture ◽  
Femoral Neck Fractures ◽  
Final Visit ◽  
Cross Sectional ◽  
Fracture Group ◽  
Significant Difference ◽  
Neck Fracture

Abstract Background:This study assessed the changes in hip muscles by comparing the preoperative and postoperative CT scan results between patients with intertrochanteric versus femoral neck fractures. Methods:48 patients who received surgical treatment for intertrochanteric or femoral neck fractures from February 2013 to February 2019 and underwent pelvic computed tomography(CT) preoperative and postoperatively aged 65 and older with a minimum follow-up of 1 year were included. The subjects were divided into two groups: 26 patients with intertrochanteric fracture and 22 patients with femoral neck fracture. We measured the cross-sectional area(CSA) and attenuation of the gluteus medius(G.med), gluteus minimus(G.min), iliopsoas(IP), and rectus femoris(RF) on the contralateral side. Patient basic data were collected from medial records including sex, age, height, weight, BMI, BMD, Harris hip score (HHS), and length of follow-up until the final visit. Results: There was no significant difference in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up until the final visit between two groups. The femoral neck fracture group had significantly larger CSA and cross-sectional area per weight(CSA/Wt) of the G.med and G.min(G.med CSA, CSA/wt preoperative 1995.29 vs 1713.64, 38.87 vs 32.74; postoperative 2144.98 vs 1815.56, 37.48 vs 32.78/G.min preoperative 745.22 vs 566.59, 14.32 vs 10.96; postoperative 764.39 vs 619.17, 14.78 vs 11.25). On the contrary, the intertrochanteric fracture group had significantly greater CSA and CSA/Wt of the IP and RF(IP preoperative 810.86 vs 661.88, 17.73 vs 9.42; postoperative 681.98 vs 571.32, 12.68 vs 9.88/RF preoperative 503.66 vs 386.72, 9.42 vs 7.23; postoperative 426.24 vs 349.31, 7.17 vs 5.23). HHS related with function had no significant correlation with postoperative CSA and CSA/Wt. There was no significant difference in attenuation between two groups. All subjects had a significant decrease of muscle attenuation postoperatively.Conclusions: The CSA of the hip abductor(G.med and G.min) was significantly larger in the femoral neck fracture group, while the CSA of the hip flexor(IP and RF) was significantly higher in the intertrochanteric fracture group. Based on these findings, choosing the rehabilitation program suitable for the fracture site is expected to be beneficial in hip fracture rehabilitation.

A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture

2018 ◽  
Vol 100-B (8) ◽  
pp. 1087-1093 ◽  
Author(s):  
B. Barenius ◽  
C. Inngul ◽  
Z. Alagic ◽  
A. Enocson
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Controlled Trial ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Neck Fracture ◽  
Euroqol 5D ◽  
Displaced Fracture

Aims The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58). Results Early differences in functional outcome, assessed using the Harris Hip Score, the Short Musculoskeletal Functional Assessment score and EuroQol-5D, with better results in cemented group, deteriorated over time and there were no statistically significant differences at 48 months. Two (3%) patients in the cemented group and five (6.8%) in the cementless group underwent further surgery for a periprosthetic fracture. This difference was statistically significant (p = 0.4). No patient underwent further surgery for instability or infection between one and four years postoperatively. The mortality and the radiological outcomes were similar in both groups. Conclusion Patients with a displaced femoral neck fracture treated with an arthroplasty using a cemented or cementless stem had good function and few complications up to four years postoperatively. However, due to the poor short-term functional outcomes in the cementless group, the findings do not support their routine use in the treatment of these elderly patients. Cite this article: Bone Joint J 2018;100-B:1087–93.

Sign in / Sign up

Export Citation Format

Share Document