Internal Fixation Compared with Total Hip Replacement for Displaced Femoral Neck Fractures

Johansson, Torsten

doi:10.2106/jbjs.k.00244

Cited by 70 publications

(20 citation statements)

References 22 publications

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“…Several studies have suggested that fracture reduction and fixation are associated with a lower rate of morbidity and mortality than treatment via prosthetic replacement [15,16]. Some reports emphasized that the multiple cannulated screws procedure is associated with low operative mortality and morbidity and a high rate of fracture union.…”

Section: Discussionmentioning

confidence: 99%

“…Some reports emphasized that the multiple cannulated screws procedure is associated with low operative mortality and morbidity and a high rate of fracture union. The surgical procedure used in the present study was based on their principle [15,17]. However, some problems that still exist in the treatment are worth noting, such as during the follow-up period, femoral neck shortening occurred in a substantial number of patients based on imaging.…”

Section: Discussionmentioning

confidence: 99%

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Incidence of and Factors Influencing Femoral Neck Shortening in Elderly Patients After Fracture Fixation with Multiple Cancellous Screws

et al. 2017

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BackgroundTo study the incidence of and factors influencing “neck shortening” in elderly patients treated for femoral neck fractures using multiple cancellous screws.Material/MethodsOf the 197 femoral neck fracture cases treated via closed reduction and cancellous screws fixation from January 2006 to February 2010, 110 were followed up. Patient age, gender, operative time, implantation method, reduction quality, fracture type, bone mineral density, loading time, length of hospital stay, and Harris hip score 12 months after operation were recorded. The patients were divided into two groups (shortening and non-shortening) based on their X-ray performance during follow-up. The healing rates and Harris hip scores of the two groups were compared, and the influencing factors of femoral neck shortening were analyzed.ResultsOf the 110 cases followed up, 94.5% (104/110) were healed and neck shortening occurred in 41.8% (46/110) within 12.5 months (mean) after treatment. The Harris hip score of the shortening group was lower than that of the non-shortening group (78±17 vs. 86±23, p=0.048). The fracture healing rates of the two groups were not significantly different (p=0.068). The factors influencing neck shortening were significantly correlated with bone mineral density, patient age, gender, and type of fracture.ConclusionsThe incidence of neck shortening in elderly patients treated for femoral neck fracture using cancellous screws was high. Bone mineral density, patient age, gender, and type of fracture were the influencing factors of neck shortening.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence of and Factors Influencing Femoral Neck Shortening in Elderly Patients After Fracture Fixation with Multiple Cancellous Screws

et al. 2017

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“…Techniques range from internal fixation with multiple cancellous lag screws and sliding hip screws for nondisplaced fractures to multiple cancellous lag screws, sliding hip screws, hemiarthroplasty, and total hip replacement for displaced femoral neck fractures [5][6][7][8]. Options for internal fixation have included a variety of implants [9,10], however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice [6][7][8][11][12][13]. Potential advantages of multiple screws over arthroplasty include short duration of surgery, limited surgical trauma and preservation of the native hip joint [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Options for internal fixation have included a variety of implants [9,10], however most recent reports and textbooks cite parallel multiple cancellous screws as the surgical technique of choice [6][7][8][11][12][13]. Potential advantages of multiple screws over arthroplasty include short duration of surgery, limited surgical trauma and preservation of the native hip joint [7,8]. The failures after multiple screws may be due to the patients' low bone mass with reduced mechanical strength, and the vulnerable blood supply to the femoral head [14].…”

Section: Introductionmentioning

confidence: 99%

Should full threaded compression screws be used in adult femoral neck fractures?

Okçu

Özkayın

Erkan

et al. 2015

Injury

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“…[11][12][13] No entanto, em pacientes idosos, há vários estudos que mostram a superioridade da artroplastia sobre a fixação interna. [14][15][16][17][18] Os resultados da artroplastia após uma fixação interna que falhou são piores do que quando se realizam artroplastias primeiramente. 19 O risco de reoperação em casos de fixação interna é de 35% em dois anos.…”

Section: -7unclassified

A qualidade de vida após a fratura do colo femoral nos idosos: um estudo comparativo entre fixação interna e artroplastias

Sansanovicz

Baras

Silva

et al. 2016

Rev. Fac. Ciênc. Méd. Sorocaba

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A qualidade de vida após a fratura do colo femoral nos idosos: um estudo comparativo entre fixação interna e artroplastiasThe quality of life after a femoral neck fracture in elderly patients: a comparative study between internal fixation and arthroplasties RESUMOIntrodução: A fratura do colo femoral é uma patologia frequente na população idosa, com cerca de 100 mil casos por ano no Brasil. O tratamento cirúrgico por meio da fixação interna ou da substituição artroplástica do quadril é preconizado atualmente. O tratamento não cirúrgico é reservado aos casos de exceção. Objetivo: Comparar a qualidade de vida pós-operatória de pacientes tratados por fratura do colo femoral por meio de duas técnicas distintas: artroplastia do quadril e fixação interna. Métodos: Por meio do questionário SF-36, estudamos a qualidade de vida de 60 pacientes com mais de 65 anos, tratados entre 2004 e 2012 em nosso serviço. Metade dos pacientes foi submetida à fixação interna e a outra metade à substituição artroplástica da articulação do quadril. Resultados: Médias mais altas na ampla maioria dos parâmetros do questionário foram obtidas pelo grupo que realizou fixação interna, porém sem significância estatística na maioria dessas diferenças. Alguns relatos internacionais sinalizam que pacientes que sofreram uma fratura do colo femoral e foram tratados com fixação interna podem retornar à qualidade de vida anterior à fratura. Paradoxalmente, na atualidade, há uma crescente tendência entre os ortopedistas em optar pela substituição articular protética da articulação do quadril nesses casos. Conclusão: Mais estudos são necessários para definir qual a melhor opção cirúrgica de tratamento. Palavras-chave: fraturas do quadril; artroplastia de quadril; fixação interna de fraturas; qualidade de vida. ABSTRACT Introduction:The femoral neck fracture is a frequent pathology in the elderly population, with about of 100,000 cases per year in Brazil. The surgical treatment by internal fixation or arthroplastic hip replacement is advocated today. The non-surgical treatment is reserved for cases of exception. Objective: To compare the quality of patient postoperative life treated for femoral neck fracture by two different techniques: hip arthroplasty and internal fixation. Methods: Through the SF-36 questionnaire, we study the quality of life of 60 patients with more than 65 years, treated between 2004 and 2012 in our service. Half of the patients was submitted to internal fixation and the other half to the arthroplastic replacement. Results: Higher averages in the large majority of the parameters of the questionnaire were obtained by the group which was carried out by internal fixation, but without statistical significance in most of these differences. Some international reports indicate that patients who have suffered a fracture of the femoral neck and were treated with internal fixation may recover the quality of life they had before the fracture. Paradoxically, there is a growing trend among orthopedic surgeons to perform a hip replacement surger...

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Internal Fixation Compared with Total Hip Replacement for Displaced Femoral Neck Fractures

Abstract: Total hip replacement is superior to internal fixation in the treatment of a displaced femoral neck fracture.

Cited by 70 publications

References 22 publications

Incidence of and Factors Influencing Femoral Neck Shortening in Elderly Patients After Fracture Fixation with Multiple Cancellous Screws

Incidence of and Factors Influencing Femoral Neck Shortening in Elderly Patients After Fracture Fixation with Multiple Cancellous Screws

Should full threaded compression screws be used in adult femoral neck fractures?

A qualidade de vida após a fratura do colo femoral nos idosos: um estudo comparativo entre fixação interna e artroplastias

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