Common complications in hip fracture surgery: Tips/tricks and solutions to avoid them

Tosounidis, Theodoros H.; Castillo, Raul; Kanakaris, Nikolaos K.; Giannoudis, Peter V.

doi:10.1016/j.injury.2015.08.006

Cited by 30 publications

(18 citation statements)

References 88 publications

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“…During the course of our study, nonsurgical and surgical complications were recorded. The complications were defined according to a selection of studies. Nonsurgical complications were defined as follows: anemia (hemoglobin <12.0 g/dL in women and <13.0 g/dL in men), electrolyte imbalance, symptomatic transitory psychotic syndrome, cardiac or pulmonary complications [myocardial infarction, pneumonia], urinary tract infection, renal dysfunction, and thromboembolism.…”

Section: Methodsmentioning

confidence: 99%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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ObjectiveInvestigation of the treatment of femur fractures and the type of femur fracture‐associated complications regarding timing of surgery and length of hospital stay.MethodsIn this retrospective cohort study, a total of 358 hip fractures were evaluated retrospectively from 1 January 2008 until 31 December 2010 at a level I trauma center in Germany. Inclusion criteria was age >18 years and a proximal femur fracture. Both sexes were evaluated. Mean age was 75.5 years, most patients were female (63.7%). Intervention was the operative treatment of proximal femur fracture. Outcome parameters were time until surgery, complications, reoperations, mortality, and length of hospital stay.ResultsAmong the proximal femur fractures (n = 358), 46.6% were pertrochanteric, 11.2% subtrochanteric, and 42.2% femoral neck fractures. Operation upon hip fractures was managed regularly within 24 hours of injury (73%; mean for femoral neck: 28.3 hrs.; mean for pertrochanteric fractures: 21.4 hrs.; mean for subtrochanteric fractures: 19.5 hrs.). Delayed treatment, as well as implantation of hip total endoprosthesis (TEP), increased the overall length of hospital stay (15.4 vs 17.6 days; 18.1 vs 15.8 days). Accordingly, surgical procedures performed within 24 hours of injury resulted in a shorter hospital residence. Longest delay of operation was measured for hip fractures (28.3 hrs.).In 351 patients, secondary injuries were detected in 94 individuals (26%), with fractures being the most common secondary injury (n = 40). We recorded postoperative complications of nonsurgical and surgical origin, and 33.6% of our patient cohort displayed complications. Complications were distributed among 118 patients. There was no significant difference in complications regarding the time of operation, with most nonsurgical and surgical complications appearing within 24 hours after operation (n = 110 vs n = 31). Nonsurgical complications, such as anemia (n = 49) and electrolyte imbalances (n = 30), were observed more frequently than surgical complications (n = 107 vs n = 34); however, these complications were reduced by delay in surgery (82.0% in 6–24 hrs. vs 74.2% in ≥24 hrs.). Anticoagulant therapy and age did not affect postoperative complications. The hospital mortality of patients was 6.2%. Follow‐up was restrained to ambulatory visits in the clinic.ConclusionsSurgical management of hip fractures performed within 24 hours of injury minimizes hospital stay. We did not detect significant differences in the spectrum or number of complications regarding delay of surgery. Surgical complications mainly occur with rapid primary care, and medical complications can be reduced by more intensive preparation of patient and operation procedures.

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Section: Methodsmentioning

confidence: 99%

Hip Fractures: Therapy, Timing, and Complication Spectrum

Saul

Riekenberg

Ammon

et al. 2019

Orthopaedic Surgery

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“…Hip fractures continue to be a significant injury in the elderly population [ 1 ]. They represent an important public health concern taking into account the complicated needs of the patients due to their medical comorbidities as well as their rehabilitation and social demands [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Thirty-day mortality after hip fractures: has anything changed?

Giannoulis

Calori

Giannoudis

2016

Eur J Orthop Surg Traumatol

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100

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Bone density insufficiency is the main cause for significant musculoskeletal trauma in the elderly population following low-energy falls. Hip fractures, in particular, represent an important public health concern taking into account the complicated needs of the patients due to their medical comorbidities as well as their rehabilitation and social demands. The annual cost for the care of these patients is estimated at around 2 billion pounds (£) in the UK and is ever growing. An increased early and late mortality rate is also recognised in these injuries together with significant adversities for the patients. Lately, in order to improve the outcomes of this special cohort of patients, fast-track care pathways and government initiatives have been implemented. It appears that these measures have contributed in a steady year-by-year reduction of the 30-day mortality rates. Whether we have currently reached a plateau or whether an ongoing reduction in mortality rates will continue to be observed is yet to be seen.

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“…Early operative treatment that allows patients to restore vertical position and improve fitness is crucial in the management of femoral neck fractures. A large number of reports on fractures on the bone-implant interface have been published so far [9,10] but none of them discusses the use of Targon FN system. The femoral shaft fracture may have resulted from "the material damage" caused by the micro-movements of the lower screw fixing the implant, which was exposed to additional stress since the upper screw was not inserted into the plate in full.…”

Section: Discussionmentioning

confidence: 99%

Peri-implant femoral shaft fracture in patient with healed femoral neck fracture treated operatively using Targon FN system

Poszepczyński¹,

Andrzejewski²,

Grabowski³

et al. 2019

Chir. Narzadow Ruchu Ortop. Pol.

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Pursuant to the recent literature recommendations, we managed 31B1 fracture with Targon FN plate (BBraun/Aesculap, Germany) in our hospital. Patient reported to our center 14 weeks after operation, complaining about pain ailments in the proximity of the operated area. Patient did not sustain any other injuries. X-ray examination revealed the healed fracture of the femoral neck and fracture below a lower screw stabilizing implant.

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Common complications in hip fracture surgery: Tips/tricks and solutions to avoid them

Cited by 30 publications

References 88 publications

Hip Fractures: Therapy, Timing, and Complication Spectrum

Hip Fractures: Therapy, Timing, and Complication Spectrum

Thirty-day mortality after hip fractures: has anything changed?

Peri-implant femoral shaft fracture in patient with healed femoral neck fracture treated operatively using Targon FN system

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