Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Sciacca, S; Lidder, SS; Grechenig, C; Grechenig, S; Staresinic, M; Bakota, B; Gänsslen, A.
Variations of treatment in selected proximal femur fractures among surgeons with different surgical experience--A survey at an international AO course.
Injury. 2015; 46 Suppl 6:S57-S60
Doi: 10.1016/j.injury.2015.10.066
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Bakota Bore
- Grechenig Stephan
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- Abstract:
- Different modalities of treatment for hip fractures have been discussed in the literature; however, practice may vary between centres. A survey was conducted on participants at an international AO course to assess the current management of pertrochanteric fractures (AO/OTA 31-A2) and displaced, non-impacted, subcapital fractures (AO/OTA 31-B3) in a 35-year-old patient and an 85-year-old patient. Surgeons taking part in an international orthopaedic course were invited to participate in a survey and were divided into two groups: inexperienced (one-to-three years since qualification) and experienced (four or more years). A survey was conducted to assess the management modalities used for pertrochanteric fractures (AO/OTA 31-A2) and displaced, non-impacted, subcapital fractures (AO/OTA 31-B3) in a 35-year-old patient and an 85-year-old patient. Fifty-two surgeons participated: 18 were inexperienced and 34 were experienced. The method of operative fixation for the pertrochanteric fracture was gamma-nailing for 95% of the surgeons in the inexperienced group; in the experienced group, 56% opted for gamma-nailing and 38% for dynamic hip screw (DHS). For the displaced subcapital fracture in a 35-year-old, screw fixation was the dominant treatment option for both groups. For the displaced subcapital fracture in an 85-year-old, most of the surgeons in both groups preferred hemiarthroplasty: 59% in the inexperienced group chose cemented bipolar hemiarthroplasty and 12% uncemented, whereas 56% of the experienced group suggested cemented bipolar hemiarthroplasty and 25% uncemented. This survey shows that a variety of methods are used to treat femoral neck fractures. A prospective randomised trial has shown the DHS to be the implant of choice for pertrochanteric fractures; however, this was not considered an option in the inexperienced group of surgeons and was the treatment of choice in only 13 out of 34 experienced surgeons. There is a general consensus for femoral head-conserving surgery in young patients with displaced subcapital fractures. Replacement arthroplasty was considered in the 85-year-old with a subcapital fracture. In the inexperienced group, 10 of 17 surgeons would cement the prosthesis, as would 27 of 36 in the experienced group. Copyright © 2015 Elsevier Ltd. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Age Factors -
- Aged -
- Aged, 80 and over -
- Arthroplasty, Replacement, Hip - statistics & numerical data
- Bone Cements -
- Clinical Competence - statistics & numerical data
- Consensus -
- Female -
- Femoral Neck Fractures - surgery
- Fracture Fixation, Internal - methods
- Health Care Surveys -
- Hemiarthroplasty - statistics & numerical data
- Humans -
- Male -
- Orthopedics - education
- Practice Patterns, Physicians' - statistics & numerical data
- Prospective Studies -
- Surgeons -
- Treatment Outcome -
- Find related publications in this database (Keywords)
- Treatment
- Proximal femur fractures
- Surgical experience
- Survey