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Archives of Orthopaedic and Trauma Surgery

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Open Access 01-08-2020 | Endoprosthesis | Trauma Surgery

Hardware removal rates after surgical treatment of proximal femur fractures

Nationwide trends in Finland in 1997–2016

Authors: Ville T. Ponkilainen, Tuomas T. Huttunen, Pekka Kannus, Ville M. Mattila

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2020

Abstract

Background

Various internal fixation methods have been used to treat proximal femur fractures and occasionally the fixation material is removed. However, nationwide trends of hardware removals are not known. Thus, this study investigated the hardware removal rates after proximal femur fractures in Finland during 1997–2016.

Materials and methods

Finnish adults aged 18 years or older in 1997–2016 formed the basic study population. From the National Hospital Discharge Register patients with trochanteric femur fracture treated with an intramedullary nail (IMN) or dynamic hip screw (DHS), and patients with femoral neck fracture treated with screw fixation, were included. Hardware removal and secondary prosthesis rates were assessed.

Results

Altogether 41,253 patients underwent proximal femoral fracture fixation surgery in Finland in 1997–2016. Of these, 16,152 were DHS surgery and 15,724 IMN surgery and 8491 underwent screw operation of femoral neck fracture. The total removal rates of DHS and IMN were 5.5% and 5.4%. The total removal rate of screw fixations of the femoral neck was higher, 18.5%. The total removal rates during the first 3 years after the IMN more than halved in 1997–2013, from 7.6% to 3.7%, whereas the removal rate of the DHS or screw fixation of femoral neck fractures did not show consistent trend. The rate of secondary prosthesis operations following DHS and IMN was low (1.8% for both). This was in clear contrast to the prosthesis rate following screw fixations of the femoral neck (7.2%).

Conclusions

IMN operations largely replaced DHS operations in trochanteric fractures of the proximal femur in Finland in 1997–2016. The removal and secondary prosthesis rates of the DHS and IMN were clearly lower than the corresponding rates after screw fixations of the femoral neck fracture.

Level of evidence

III, Epidemiologic study.

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Title: Hardware removal rates after surgical treatment of proximal femur fractures
Nationwide trends in Finland in 1997–2016
Authors: Ville T. Ponkilainen
Tuomas T. Huttunen
Pekka Kannus
Ville M. Mattila
Publication date: 01-08-2020
Publisher: Springer Berlin Heidelberg
Keywords: Endoprosthesis
Dynamic Hip Screw
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03356-z

At a glance: The STEP trials

Springer Medicine

Hardware removal rates after surgical treatment of proximal femur fractures

Nationwide trends in Finland in 1997–2016

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence

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