Internal fixation versus hemiarthroplasty for displaced femoral neck fractures in the elderly: A cost-effectiveness analysis

Liu, Haonan; Li, Ning; Zhang, Xuejun; He, Li; Li, Duoyi; Li, Yuneng; Zhao, Gang; Wu, Xinbao

doi:10.1016/j.injury.2020.03.002

Cited by 7 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Several studies have shown that IF may be more cost-effective than hip arthroplasty. 11,35,37 Additionally, there are some unique problems after hip arthroplasty to consider, such as metal ion release, ceramic fracture, and noise. 38,39 In the present study, between a quarter and a third of patients aged 50 to 70 years had stable fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Hospitalized elderly patients with hip fracture usually need interdisciplinary management, and the treatment cost is generally higher than that for other types of fracture. 9 – 11 Patients who are able to choose and decide to undergo hip arthroplasty rather than internal fixation (IF) may not only lose the opportunity to preserve their native hip joint but may also have a large economic burden that is shared by their family and medical insurance institutions. In 2018, the International Comprehensive Classification of Fractures and Dislocations Committee proposed a new classification of FNF, 12 called the new AO classification.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Proportion of stable femoral neck fracture types in different age groups: a population-based study

et al. 2022

View full text Add to dashboard Cite

Objective The treatment and incidence of femoral neck fracture (FNF) in older patients is controversial. We investigated the new AO (Arbeitsgemeinschaft für Osteosynthese) classification in patients with FNF by age to determine the proportions of stable fracture and change trends according to patients’ age. Methods We divided patients with FNF hospitalized in Xi'an Honghui Hospital from 2018 to 2020 into five groups according to age: young (<50 years), middle-aged (50–59 years), young-elderly (60–69 years), middle-elderly (70–79 years), and very elderly (≥80 years) groups. We retrospectively collected data of patients’ sex, admission date, fracture side, mechanism of injury, and new AO classification. Results In total, 2071 patients were included for analysis, with 1329 women (64.2%); 1106 patients (53.4%) had left-side fracture. The main mechanism of injury was falling. In the young-elderly, middle-elderly, and very-elderly groups, 33.3%, 29.2%, and 24.1% had stable fracture type, respectively). The proportion of patients with FNF did not show a change trend by age during the 3-year investigation period. Conclusion In our study, the proportion of older patients with FNF did not increase, and as many as a third of patients with FNF aged 50 to 70 years had stable fracture.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proportion of stable femoral neck fracture types in different age groups: a population-based study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Among them, some patients may achieve satisfactory results as long as they are treated with IF.Their study demonstrates that patients undergoing THA had higher in hospital complication rates and longer length of stay than patients undergoing IF. The in-hospital mortality for patients undergoing a hip hemiarthroplasty(HA) was higher (1.2%) than either THA (0.2%) or IF (0.5%).Two studies of nondisplaced FNF patients over the age of 70 found that among patients receiving IF and the arthroplasty, patients treated with arthroplasty had higher 30-days mortality rate(11%)( 16) and patients treated with internal xation have a higher 2-year mortality rate(36%) (17).Several studies have shown that IF may be more cost-effective than hip arthroplasty because the total cost is less (15,18,19).Lagergrenet et al (20)reported that HA with baseline results in patient reported outcome measure indicating poorer health and function, as well as higher mortality and lower response rates with patients aged 60-69.IF tend to fail in up to 1/3 of the cases but can offer the bene ts of a biologically intact hip if successful.In young elderly people, it is still worth for doctors to choose IF to preserve the native hip joint among the appropriate fracture types.…”

Section: Discussionmentioning

confidence: 99%

Distribution Characteristics of New AO Classification in Different Age Groups of Patients with Femoral Neck Fracture

Jiang

Feng

Huang

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective: Femoral neck fractures(FNFs) patients from 2018 to 2020 were classified according to the new AO classification. To observe the proportion of new AO classification and provide reference for improving the upper age limit of internal fixation(IF) treatmentMethods: In this study, patients with femoral neck fracture hospitalized in Xi 'an Honghui Hospital from January 2018 to January 2021 were divided into four groups according to age: the young group (≤44 years old), the middle-aged group (45-59 years old),the young elderly group (60-74 years old), and the elderly group (≥75 years old) to analyze age,sex,side,injury mechanism,new AO classification and other features . A total of 2071 patients were included for analysis.Results: There were 742 males (35.8%) and 1,329 females (64.2%).There were 1,106 patient s(53.4%) on the left side and 965 on the right side (46.6%).There were 1781 patients of low energy injury (86%) and 290 patients of high energy injury (14%), and the main injury mechanism was falling.The number of patients with femoral neck fracture in each year was 719 patients in 2018, 694 patients in 2019, and 661 patients in 2020, respectively. The number of patients showed a decreasing trend year by year, and the gender ratio and injury mechanism showed no significant trend of change. In the age group, the proportion of the young group was increasing year by year.Among the new AO classification, there were 1023 patients of B1.3, accounting for the highest proportion of 49.4%.The proportion of B2.2 was the highest in the young group (32.4%) .B1.3 and B2.2 were the main types in the middle-aged group, accounting for 31.7% and 32.0, respectively.B1.3 was dominant in the young elderly and elderly group (47.1% and 63.4%, respectively).Conclusion: The new AO classification is more detailed and practical. 1/3 of the fracture types of middle aged and young elderly people may achieve satisfactory results through IF.Level of evidence: III.

show abstract

Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes

Lee

Chang

et al. 2023

The Journal of Arthroplasty

View full text Add to dashboard Cite

Internal fixation versus hemiarthroplasty for displaced femoral neck fractures in the elderly: A cost-effectiveness analysis

Cited by 7 publications

References 21 publications

Proportion of stable femoral neck fracture types in different age groups: a population-based study

Proportion of stable femoral neck fracture types in different age groups: a population-based study

Distribution Characteristics of New AO Classification in Different Age Groups of Patients with Femoral Neck Fracture

Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes

Contact Info

Product

Resources

About