A survey of the treatment of displaced intracapsular femoral neck fractures in the UK

Crossman, P.; Khan, Riaz J.K.; MacDowell, A.; Gardner, Adrian; Reddy, N.S; Keene, G

doi:10.1016/s0020-1383(02)00002-5

Cited by 59 publications

(40 citation statements)

References 32 publications

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“…**Pauwels classification could not be determined for eight patients. The decision tree could not be completed for these patients evidence on the treatment of these patient subgroups is reflected in our results [6,7,14]. A second reason for treatment inconsistency could be the shifting age limit for internal fixation of elderly with displaced fractures in the last decade.…”

Section: Guideline Adherencementioning

confidence: 88%

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Adherence to a femoral neck fracture treatment guideline

Zielinski

Meeuwis

Heetveld

et al. 2013

International Orthopaedics (SICOT)

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Purpose In 2007 the Dutch Surgical Society published a clinical practice guideline for the treatment of hip fracture patients, based on the best available international evidence at that time. We investigated to what extent treatment of femoral neck fracture patients in the Netherlands corresponded with these guidelines, and determined differences in patient characteristics between the treatment groups. Methods All femoral neck fracture patients treated in 14 hospitals between February 2008 and August 2009 were included. Patient characteristics, X-rays, and treatment data were collected retrospectively.Results From a total of 1,250 patients 59 % had been treated with arthroplasty, 39 % with internal fixation, and 2 % with a non-operative treatment. While 74 % of the treatment choices complied with the guideline, 12 % did not. In 14 % adherence could not be determined from the available data. Arthroplasty was preferred over internal fixation in elderly patients with severe comorbidity, pre-fracture osteoporosis and a displaced fracture, who were ambulatory with aids pre-fracture (odds ratio, OR 2.2-58

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Section: Guideline Adherencementioning

confidence: 88%

“…There is no clear consensus on the treatment of younger patients with a displaced fracture [6,7,9,10,[14][15][16]. From meta-analyses it is known that internal fixation may lead to lower infection rates, less blood loss, a shorter operative time, and possibly a decrease in mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Adherence to a femoral neck fracture treatment guideline

Zielinski

Meeuwis

Heetveld

et al. 2013

International Orthopaedics (SICOT)

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“…2 Femoral neck fracture is a most common injury which can lead to increased postoperative morbidity and mortality in elderly patients. Hemiarthroplasty, as an effective treatment [3][4] , contributes to early ambulation and good functional recovery. However, there has been persistent controversy over whether cemented hemiarhroplasty or uncemented hemiarthroplasty is preferable for the patient population.…”

Section: Introductionmentioning

confidence: 99%

Cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures

Chaurasia

Charan

2018

Int J Res Orthop

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Background: This study compared functional outcome and results between cemented and uncemented bipolar hemiarthroplasty in patients older than 60 years with displaced femoral neck fracture.Methods: Total fifty four patients with displaced femoral neck fracture were enrolled in this study. Out of total twenty eight patients underwent uncemented bipolar hemiarthroplasty and remaining twenty six patients underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patient’s pain and functions were evaluated with visual analogue scale and Harris Hip Score and then compared to each other.Results: All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in cemented group compared to the uncemented group (p>0.05). The mean pain score was significantly less in the cemented group compared to the uncemented group (p=0.001). Hip functional outcome based on HHS was more in the cemented (p=0.001). The intraoperative and postoperative complication rate was higher in the uncemented group (p<0.05).Conclusions: Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complication and improve patient’s function in less time.

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“…2 However, following the advent of bone cement, the Thompson prosthesis is cemented at most centres in the United Kingdom. 1 There has been considerable debate over the use of cement in hemiarthroplasty of the hip for fracture neck of femur. 1,3,4 The claimed advantages of cemented prosthesis are the decreased postoperative thigh pain 3e7 resulting in better mobility, 5e8 lower incidence of aseptic loosening, 4,8e10 and periprosthetic fractures.…”

Section: Introductionmentioning

confidence: 99%

“…1 There has been considerable debate over the use of cement in hemiarthroplasty of the hip for fracture neck of femur. 1,3,4 The claimed advantages of cemented prosthesis are the decreased postoperative thigh pain 3e7 resulting in better mobility, 5e8 lower incidence of aseptic loosening, 4,8e10 and periprosthetic fractures. 10 However, the uncemented hemiarthroplasty is favoured by some surgeons as it eliminates the cement-related morbidity and mortality 3,11e13 and reduces operating time, 4,14 thereby reducing the postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of the Postoperative Morbidity and Mortality in Femoral Neck Fractures in Elderly Patients Treated with Cemented and Uncemented Thompson Hemiarthroplasty

Gowtham

Gubbi

Prasad

2011

Journal of Orthopaedics, Trauma and Rehabilitation

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a b s t r a c tBackground: Thompson hip hemiarthroplasty is a well-established procedure for the treatment of displaced intracapsular fracture neck of femur in the elderly. However, considerable debate exists regarding the use of cemented prosthesis in this elderly group of patients. The main purpose of our study was to analyse the outcomes following cemented and uncemented Thompson hemiarthroplasty of the hip with particular reference to cement-related morbidity and 30-day mortality. Methods: Of the 110 patients who underwent Thompson hemiarthroplasty for intracapsular hip fracture, 30 (27.3%) had cemented and 80 (72.7%) had uncemented prosthesis. The mean age was 83.2 years with 87 female patients. The thigh pain and mobility at discharge, the inpatient complications and the 30-day mortality rates were compared between the cemented and uncemented groups. Results: The study revealed no statistically significant differences in any of the postoperative outcome measures between the two groups. Conclusion: Cemented and uncemented Thompson hip hemiarthroplasty have similar outcomes at discharge. Patients who underwent cementation without pressurisation did not show any higher incidence of bone cement implantation syndrome compared to their uncemented counterparts. Uncemented Thompson hemiarthroplasty can be an option in patients with very poor cardiopulmonary reserve without any significant complications in the short term.

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A survey of the treatment of displaced intracapsular femoral neck fractures in the UK

Cited by 59 publications

References 32 publications

Adherence to a femoral neck fracture treatment guideline

Adherence to a femoral neck fracture treatment guideline

Cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures

A Comparative Study of the Postoperative Morbidity and Mortality in Femoral Neck Fractures in Elderly Patients Treated with Cemented and Uncemented Thompson Hemiarthroplasty

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