Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 5/2011

01-10-2011 | Original Article

Correlation between risk factors and subsequent surgical management following internal fixation of intracapsular femoral neck fractures in patients under the age of 60 years

Authors: A. Sebestyén, F. Tóth, J. Sándor, J. Nyárády, I. Boncz

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2011

Login to get access

Abstract

Purpose

Regarding intracapsular femoral neck fractures, the main focus of research is the correlation between fracture-related complications and prognostic factors. To evaluate the correlation between complications required surgery (fracture-related treatment) and, among others, several less extensively investigated prognostic factors (day of surgery, co-morbidities, hospital type) in a 2-year period following internal fixation in patients under the age of 60 years with intracapsular femoral neck fracture.

Methods

A retrospective analysis of femoral neck fractures occurring in Hungary in 2000 was undertaken, based on data obtained from the National Health Insurance Fund Administration. The data were validated and completed by a questionnaire carried out in all of the 60 institutions enrolled. The effects of prognostic factors were analyzed by uni- and multivariate logistic regression in three groups: all fracture-related treatments and non-prosthetic (NPT) and prosthetic treatments (PT).

Results

Out of 413 patients, 17.9% required further fracture-related treatment. In 7.7% of patients, NPT and in 10.2% of patients, PT was performed. Fracture displacement (odds ratio [OR] = 2.24), weekend surgery (OR = 2.35), infections (OR = 3.68), central nervous system-related co-morbidities (OR = 3.64), and the county hospital level of management (OR = 2.36) were associated with significantly increased risk for further surgery.

Conclusions

To reduce the influence of risk factors, standardization of the substantive traumatologic and orthopedic professional guidelines, as well as the introduction of the “common orthopedic-trauma patient care” (British model) are suggested. To achieve high-quality standardized patient management, personal and material conditions are required to be accessible every day of the week. In the presence of co-morbidities, reduction of their harmful effects should be a major consideration by focusing on the patient in the peri-operative periods.
Literature
1.
Parker MJ, Raghavan R, Gurusamy K. Incidence of fracture-healing complications after femoral neck fractures. Clin Orthop Relat Res. 2007;458:175–9.PubMed
2.
Shih CH, Wang KC. Femoral neck fractures. 121 cases treated by Knowles pinning. Clin Orthop Relat Res. 1991;271:195–200.PubMed
3.
Damany DS, Parker MJ, Chojnowski A. Complications after intracapsular hip fractures in young adults. A meta-analysis of 18 published studies involving 564 fractures. Injury. 2005;36:131–41.PubMed
4.
Bosch U, Schreiber T, Skutek M, Cserháti P, Fekete K, Krettek C. Minimally invasive screw fixation of the intracapsular femoral neck fracture in elderly patients. Chirurg. 2001;72:1292–7.PubMedCrossRef
5.
Tidermark J, Zethraeus N, Svensson O, Törnkvist H, Ponzer S. Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation. J Orthop Trauma. 2002;16:34–8.PubMedCrossRef
6.
Skála-Rosenbaum J, Dzupa V, Bartonícek J, Dousa P, Pazdírek P. Osteosynthesis of intracapsular femoral neck fractures. Rozhl Chir. 2005;84:291–8.PubMed
7.
Rodríguez-Merchán EC. In situ fixation of nondisplaced intracapsular fractures of the proximal femur. Clin Orthop Relat Res. 2002;399:42–51.PubMedCrossRef
8.
Conn KS, Parker MJ. Undisplaced intracapsular hip fractures: results of internal fixation in 375 patients. Clin Orthop Relat Res. 2004;421:249–54.PubMedCrossRef
9.
Upadhyay A, Jain P, Mishra P, Maini L, Gautum VK, Dhaon BK. Delayed internal fixation of fractures of the neck of the femur in young adults. A prospective, randomised study comparing closed and open reduction. J Bone Joint Surg Br. 2004;86:1035–40.PubMedCrossRef
10.
Gurusamy K, Parker MJ, Rowlands TK. The complications of displaced intracapsular fractures of the hip: the effect of screw positioning and angulation on fracture healing. J Bone Joint Surg Br. 2005;87:632–4.PubMedCrossRef
11.
Toh EM, Sahni V, Acharya A, Denton JS. Management of intracapsular femoral neck fractures in the elderly; is it time to rethink our strategy? Injury. 2004;35:125–9.PubMedCrossRef
12.
Farooq MA, Orkazai SH, Okusanya O, Devitt AT. Intracapsular fractures of the femoral neck in younger patients. Ir J Med Sci. 2005;174:42–5.PubMedCrossRef
13.
Jain R, Koo M, Kreder HJ, Schemitsch EH, Davey JR, Mahomed NN. Comparison of early and delayed fixation of subcapital hip fractures in patients sixty years of age or less. J Bone Joint Surg Am. 2002;84-A(9):1605–12.PubMed
14.
Rajan DT, Parker MJ. Does the level of an intracapsular femoral fracture influence fracture healing after internal fixation? A study of 411 patients. Injury. 2001;32:53–6.PubMedCrossRef
15.
Karaeminogullari O, Demirors H, Atabek M, Tuncay C, Tandogan R, Ozalay M. Avascular necrosis and nonunion after osteosynthesis of femoral neck fractures: effect of fracture displacement and time to surgery. Adv Ther. 2004;21:335–42.PubMedCrossRef
16.
Dorotka R, Schoechtner H, Buchinger W. Influence of nocturnal surgery on mortality and complications in patients with hip fractures. Unfallchirurg. 2003;106:287–93.PubMedCrossRef
17.
Parker MJ, Banajee A. Surgical approaches and ancillary techniques for internal fixation of intracapsular proximal femoral fractures. Cochrane Database Syst Rev. 2005;18(2):CD001705.
18.
Haidukewych GJ, Rothwell WS, Jacofsky DJ, Torchia ME, Berry DJ. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004;86-A(8):1711–6.PubMed
19.
Muraki S, Yamamoto S, Ishibashi H, Nakamura K. Factors associated with mortality following hip fracture in Japan. J Bone Miner Metab. 2006;24:100–4.PubMedCrossRef
20.
Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331:1374–6.PubMedCrossRef
21.
Weller I, Wai EK, Jaglal S, Kreder HJ. The effect of hospital type and surgical delay on mortality after surgery for hip fracture. J Bone Joint Surg Br. 2005;87-B:361–6.CrossRef
22.
Foss NB, Kehlet H. Short-term mortality in hip fracture patients admitted during weekends and holidays. Br J Anaesth. 2006;96:450–4.PubMedCrossRef
23.
Karagiannis A, Papakitsou E, Dretakis K, Galanos A, Megas P, Lambiris E, Lyritis GP. Mortality rates of patients with a hip fracture in a southwestern district of Greece: ten-year follow-up with reference to the type of fracture. Calcif Tissue Int. 2006;78:72–7.PubMedCrossRef
24.
Bottle A, Aylin P. Mortality associated with delay in operation after hip fracture: observational study. BMJ. 2006;332:947–51.PubMedCrossRef
25.
Orosz GM, Magaziner J, Hannan EL, Morrison RS, Koval K, Gilbert M, McLaughlin M, Halm EA, Wang JJ, Litke A, Silberzweig SB, Siu AL. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004;291:1738–43.PubMedCrossRef
26.
Raaymakers EL. Fractures of the femoral neck: a review and personal statement. Acta Chir Orthop Traumatol Cech. 2006;73:45–59.PubMed
27.
Nikolopoulos KE, Papadakis SA, Kateros KT, Themistocleous GS, Vlamis JA, Papagelopoulos PJ, Nikiforidis PA. Long-term outcome of patients with avascular necrosis, after internal fixation of femoral neck fractures. Injury. 2003;34:525–8.PubMedCrossRef
28.
Sträuli C, Seekamp A, Lehmann U, Bosch U. Bone screw osteosynthesis of medial femoral neck fracture in elderly patients. Swiss Surg. 2001;7:167–72.PubMedCrossRef
29.
Statistics on hospital beds and patient discharge 2002. Szekszárd, Hungary: Information Centre for Health Care of the Ministry of Health; 2003.
Metadata
Title
Correlation between risk factors and subsequent surgical management following internal fixation of intracapsular femoral neck fractures in patients under the age of 60 years
Authors
A. Sebestyén
F. Tóth
J. Sándor
J. Nyárády
I. Boncz
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
European Journal of Trauma and Emergency Surgery / Issue 5/2011
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-010-0072-3

Other articles of this Issue 5/2011

European Journal of Trauma and Emergency Surgery 5/2011 Go to the issue

Letter

Response to the comment of Brusselaers et al. questioning the clinical benefit of circulating free DNA/neutrophil extracellular traps (cfDNA/NETs) as a laboratory marker for outcome prediction after severe burn injuries

Original Article

Thromboprophylaxis following major skeletal trauma: a systematic review

Original Article

Influence of timing and oral anticoagulant/antiplatelet therapy on outcomes of patients affected by hip fractures

Editorial

Series on vascular injuries: complex injuries and difficult problems. Surgical strategies for their management

Review Article

Brachial vessel injuries: high morbidity and low mortality injuries

Review Article

Risk assessment and management in hand and facial tissue transplantation