Conservative or surgical treatment of undisplaced (impacted) femoral neck fractures?

Manninger, J; Kazár, G; Salacz, T; Varga, Ákos János; Pannike, A.

doi:10.1007/bf02588007

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…1 ) were finally included; these dealt with patients with undisplaced FNFs who were managed either non-operatively or operatively. After careful inspection, we found that >50% of the patients were lost to follow-up in the study of Manninger et al [ 16 ] Additionally, in another study, patients in the surgical group had initially received conservative therapy [ 18 ]. We excluded both studies; 29 studies thus remained.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis

et al. 2017

J Orthop Surg Res

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BackgroundIt remains unclear whether conservative treatment should be used to treat the common undisplaced femoral neck fractures that develop in the elderly. Herein, we systematically review the rates of union and avascular necrosis after conservative and surgical treatment of undisplaced femoral neck fractures.MethodsWe searched the EMBASE, PubMed, OVID, Cochrane Library, Web of Science, and Scopus databases for randomized controlled trials or observational studies that assessed the outcomes of conservative or surgical treatments of undisplaced femoral neck fractures. No language or publication year limitation was imposed. Statistical analyses were performed with the aid of the chi-squared test. We evaluated the quality of each publication and the risk of bias.ResultsTwenty-nine studies involving 5071 patients were ultimately included; 1120 patients were treated conservatively and 3951 surgically. The union rates were 68.8% (642/933) and 92.6% (635/686) in the former and latter groups, respectively (p < 0.001). The avascular necrosis rate in the conservatively treated group was 10.3% (39/380), while it was 7.7% (159/2074) in the surgically treated group (p = 0.09).ConclusionsSurgery to treat undisplaced femoral neck fractures was associated with a higher union rate and a tendency toward less avascular necrosis than conservative treatment.

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Section: Resultsmentioning

confidence: 99%

A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis

et al. 2017

J Orthop Surg Res

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“…Conservative treatment proponents point out that because most patients would heal without internal fixation when adequately supervised, the risks associated with the operation are not justified in preventing displacement in a tiny fraction of cases (12). Others support using hip arthroplasty to treat elderly patients with non-displaced or impacted NOF fractures to promote early mobility, recovery and lower mortality (13)(14)(15)31). Hemiarthroplasty is thus advised for patients above the age of 75.…”

Section: Groupsmentioning

confidence: 99%

“…The best course of treatment for impacted NOF fractures is still up for debate, and the research in this field is generally lacking. While some surgeons advocate primary surgical stabilisation, others have found positive outcomes with conservative therapy (7)(8)(9)(10)(11)(12)(13)(14)(15). According to reports, the non-operative approach has a success rate of about 85%; however, no published data discusses non-operative treatment indications (10).…”

Section: Introductionmentioning

confidence: 99%

The Role of Frailty Scores to Predict the Outcomes in Non Operative Treatment of Valgus Impacted Neck of Femur Fractures

Ali,

Neo,

Rajeev

et al. 2023

Acta Med. (Hradec Kralove, Czech Repub.)

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Objectives: The management of valgus-impacted neck of femur fracture is controversial between operative and conservative treatments. This study aimed to investigate the usefulness of the Clinical frailty Score for predicting the prognosis of patients who underwent non-operative treatment for the valgus-impacted neck of femur fracture (NOF). Methods: A single-centred retrospective review of patients admitted with valgus impacted NOF. Data were collected from patients’ records, including demographics, Clinical Frailty Score (CFS), Nottingham Hip Fracture Score (NHFS) and Abbreviated Mental Test Score (AMTS). Patients were followed up to 24 months postoperatively. Results: Fifty-eight patients who were treated non-operatively with a mean follow-up of 2.6 years met our inclusion criteria. Twenty-nine patients failed the non-operative treatment and required replacement surgeries, while 29 had successful outcomes (50%). There were no differences between the two groups’ mean age and gender distributions (P 0.527 and 0.139, respectively). The successful group had significantly higher CFS (P 0.013), worse AMTS and higher mortality risk based on the NHFS (P 0.006 and P < 0.001, respectively). Conclusion: This study demonstrates that CFS, AMTS and NHFS can be used as predictors when considering non-operative treatment for the valgus-impacted neck of femur fracture. Patients who are frail, demented and high risk based on the NHFS have higher success rates with non-operative treatment.

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Schenkelhalsfrakturen

Kundel¹

2011

Tscherne Unfallchirurgie

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Conservative or surgical treatment of undisplaced (impacted) femoral neck fractures?

Cited by 7 publications

References 17 publications

A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis

A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis

The Role of Frailty Scores to Predict the Outcomes in Non Operative Treatment of Valgus Impacted Neck of Femur Fractures

Schenkelhalsfrakturen

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