Undisplaced Intracapsular Hip Fractures

Conn, Kevin S.; Parker, Martyn J.

doi:10.1097/01.blo.0000119459.00792.c1

Cited by 132 publications

(26 citation statements)

References 24 publications

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“…A conversion to hip arthroplasty is usually necessary to restore mobility and relieve pain [1, 3, 5]. Several other reasons such as periimplant fracture and hardware irritation that required a revision surgery (fracture fixation and removal of implant, respectively) are other reasons that may result in additional surgeries [1, 3–5, 9, 11–13, 22]. For patients that received hemiarthroplasty, periprosthetic joint infection, dislocation, and prosthesis loosening were the most common causes of reoperation [11, 13].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis

et al. 2019

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Background Although internal fixation has been the main treatment option for elderly patients with an undisplaced femoral neck fracture, it is associated with a high reoperation rate. Some surgeons have discussed the use of hemiarthroplasty, but there is limited literature comparing these two treatment modalities. In this study, we compared the perioperative results of hemiarthroplasty with internal fixation for undisplaced femoral neck fractures. Methods We performed a comprehensive review of literatures on PubMed, Web of Science, Embase, and the Cochrane Library for randomized controlled trials and comparative observational studies. Of the 441 studies initially identified, 3 met all inclusion criteria. Two reviewers independently graded study quality and abstracted relevant data including reoperation rate, mortality rate, Harris Hip Score (HHS), length of hospital stay, and operation duration. Results Our results revealed that hemiarthroplasty was associated with a lower reoperation rate than the internal fixation group (OR 4.489; 95% CI 2.030 to 9.927). Mortality rate at postoperative 1 month and 1 year and HHS at postoperative 1 year and 2 years were not different. Length of hospital stay (SMD − 0.800, 95% CI − 1.011 to − 0.589) and operation duration (SMD − 2.497, 95% CI − 2.801 to − 2.193) were shorter in the internal fixation group. Conclusions Compared with the internal fixation group, patients that underwent hemiarthroplasty had a lower reoperation rate and an equivalent overall mortality rate. Our meta-analysis suggests that hemiarthroplasty might be a better treatment choice than internal fixation in treating elderly patients with an undisplaced femoral neck fracture.

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Section: Discussionmentioning

confidence: 99%

Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis

et al. 2019

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“…However, alternative treatments are conservative treatment or replacement arthroplasty. A review study by Conn and Parker confirmed a non-union rate of 30–45 % for conservative treatment [11]. The recent review study concluded that the non-union rate with secondary displacement was at least 30 % for the conservative treatment of undisplaced femoral neck fractures [13].…”

Section: Discussionmentioning

confidence: 99%

“…To avoid the complications of avascular necrosis and non-union, arthroplasty was advocated in the treatment of undisplaced femoral neck fractures [17]. However, hemi-arthroplasty is complicated by deep infection (3 %), superficial infection (15 %), periprosthetic fracture (3 %), dislocation (5 %), loosening (10 %), acetabular wear (20 %) and a potentially higher mortality compared to internal fixation [11]. …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless internal fixation is not without complications. Parker described 6.4 % non-union, 4.0 % avascular necrosis and revision surgery in 7.7 % [11]. The review study by Van Embden demonstrated a non-union rate of 4–8.5 %, avascular necrosis in 2–4 % and revision surgery of 8–15 % after osteosynthesis of undisplaced femoral neck fractures [13].…”

Section: Discussionmentioning

confidence: 99%

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Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures

Walsum

Vroemen

Janzing

et al. 2016

Eur J Trauma Emerg Surg

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BackgroundThis study evaluated the clinical results of a new implant in the internal fixation of undisplaced femoral neck fractures.MethodIrrespective of their age, 149 patients with undisplaced (Garden I and II) femoral neck fractures were included in a prospective multicentre clinical cohort study and were treated by internal fixation by means of the Dynamic Locking Blade Plate (DLBP). The mean age was 69 years and the follow-up at least one year.ResultsThe DLBP fixation resulted in 6 out of 149 failures caused by AVN (2x), non-union (2x), loss of fixation (3x) or combination of these.ConclusionThe fixation of undisplaced femoral neck fractures by the DLBP resulted in a low failure rate of 4 %.

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“…A safe solution for this problem would certainly be to use of hip replacement procedures in the majority of the cases [33]. On the other hand, this also means that many fractures with the potential for uneventful healing would be replaced.…”

Section: Discussionmentioning

confidence: 99%

On-table decision-making in intracapsular hip fracture surgery: mid-term results of a pilot study

Hartel

Mandani

Nuechtern

et al. 2016

Arch Orthop Trauma Surg

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Undisplaced Intracapsular Hip Fractures

Cited by 132 publications

References 24 publications

Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis

Outcomes of internal fixation versus hemiarthroplasty for elderly patients with an undisplaced femoral neck fracture: a systematic review and meta-analysis

Low failure rate by means of DLBP fixation of undisplaced femoral neck fractures

On-table decision-making in intracapsular hip fracture surgery: mid-term results of a pilot study

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