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Archives of Orthopaedic and Trauma Surgery

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03-08-2021 | Trauma Surgery

Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship

Authors: Michael J. VanWagner, Steven B. Porter, Aaron C. Spaulding, Glenn G. Shi, Benjamin K. Wilke, Cameron K. Ledford

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2022

Abstract

Background

Solid organ transplantation (SOT) recipients have complex medical and surgical risk factors; however, the outcomes of these patients undergoing surgical fixation of hip fractures are unknown. This study sought to evaluate SOT patients’ outcomes and survivorship after intertrochanteric (IT) fracture fixation.

Methods

A retrospective review identified 12 SOT patients who underwent cephalomedullary (CMN) nail fixation for IT fractures and were matched (1:2) to a cohort of 24 non-SOT IT fracture patients. Perioperative results and complications, mortality/patient survivorship, and clinical outcomes were compared between the cohorts.

Results

The time from presentation to surgical fixation was within 48 h of presentation for the non-SOT patients, while only 75% of SOT patients underwent surgery within 48 h of presentation (p = 0.034). The 90-day readmission rate for SOT patients was 25% versus 13% in the non-SOT group (p = 0.38). Similarly, the SOT cohort experienced a higher rate of major medical complication (25% vs. 13%, p = 0.38). There were two (16%) reoperations in the SOT group and three (13%) in the non-SOT matched group (p = 0.99). Respectively, the 90-day and 1-year estimated patient survivorship was similar between the two cohorts: SOT patients with 92% (95% CI 54–99%) and 73% (95% CI 24–93%) versus 86% (95% CI 62–95%) and 72% (95% CI 47–86%, HR 0.92, 95% CI 0.18–4.62, p = 0.92) in non-SOT patients.

Conclusion

SOT patients who underwent CMN fixation for IT fractures required more time from hospital presentation to surgical management than non-SOT patients. Although not statistically significant, SOT patients demonstrated more acute complications and readmissions, but similar mortality compared to those without transplant.

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Title: Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship
Authors: Michael J. VanWagner
Steven B. Porter
Aaron C. Spaulding
Glenn G. Shi
Benjamin K. Wilke
Cameron K. Ledford
Publication date: 03-08-2021
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04096-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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