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Labmayr, V; Borenich, A; Pusch, T; Reinbacher, P; Hauer, G; Sadoghi, P; Leithner, A; Berghold, A; Puchwein, P.
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.
Geriatr Orthop Surg Rehabil. 2023; 14: 21514593231164105 Doi: 10.1177/21514593231164105 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Führende Autor*innen der Med Uni Graz
Labmayr Viktor
Co-Autor*innen der Med Uni Graz
Berghold Andrea
Borenich Andrea
Hauer Georg
Leithner Andreas
Puchwein Paul
Reinbacher Patrick
Sadoghi Patrick
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Abstract:
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.

Find related publications in this database (Keywords)
geriatric trauma
hip fracture
femoral neck fracture
osteosynthesis
lower extremity surgery
open reduction internal fixation
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