المؤلفون: Chengzhi Liang, Yuan Cao, Zhihao Lin, Guoming Liu, Chengdong Zhang, Yanling Hu

المصدر: BMC Musculoskeletal Disorders, Vol 24, Iss 1, Pp 1-8 (2023)

مصطلحات موضوعية: Displaced femoral neck fracture, Femoral neck system (FNS), Direct anterior approach (DAA), Open reduction, Diseases of the musculoskeletal system, RC925-935

الوصف: Abstract Background Most displaced femoral neck fractures can achieve satisfactory anatomical reduction by closed reduction, but there are still some that cannot reset satisfactorily after closed reduction, and open reduction are required. Such fractures that cannot be repositioned successfully by closed reduction are called irreducible displaced femoral neck fractures in this study. The objective of our study was to evaluate the efficacy of direct anterior incision with the Femoral Neck System in the treatment of irreducible displaced femoral fractures. Methods A total of 16 young and middle-aged patients with irreducible displaced femoral neck fractures involving Garden type III and IV were treated using Femoral Neck System fixation by open reduction through Direct Anterior Approach between January 2020 to September 2021. Functional outcomes and postoperative complications were assessed during follow-up. Clinical outcomes were evaluated by the Hip Harris score. The postoperative reduction was evaluated by the Garden Index. Observe postoperative complications. Results All patients were followed up with a mean follow-up time of 21.1(12–30) months, and according to radiological results, all patients achieved fracture healing, with a mean healing time of 4.25 months. All 16 patients received grade Garden I and II reductions, and there was no significant difference in the anteroposterior Garden reduction index between the first day after surgery (166.13 ± 5.61) and the 12th month after surgery(164.94 ± 4.49) (P>0.05) and no significant difference in lateral Garden index between the first day after surgery(171.06 ± 4.46) and the 12th month after surgery(169.38 ± 3.98) (P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2474Test

الوصول الحر: https://doaj.org/article/b90d74a9cf084de8aeff587014b82c6eTest

المؤلفون: Santong Luo, Wupeng Qin, Lizhi Yu, Raoshan Luo, Weiming Liang

المصدر: BMC Musculoskeletal Disorders, Vol 24, Iss 1, Pp 1-6 (2023)

مصطلحات موضوعية: Displaced femoral neck fracture, Total hip arthroplasty, Hemiarthroplasty, Diseases of the musculoskeletal system, RC925-935

الوصف: Abstract Background Femoral neck fractures are associated with substantial morbidity and mortality for older adults. Total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used in elderly patients with displaced femoral neck fractures (DFNF), but there is still controversy refering to the optimal chose for the management of DFNF in active elderly patients. Methods This is a retrospective cohort study that incorporates medical record review with an outcomes management database. 73 patients who underwent HA and 66 patients who underwent THA were identified from January 2015 to December 2017. Data of age, gender, BMI, comorbidity status, operation time, blood loss, hospitalization time, in-hospital complication were collected and analyzed. Clinical follow-up and radiographic examinations were performed at approximately five years, and hip complications, Harris Hip Score (HHS) and EuroQol-5 Dimensions (EQ-5D) were assessed. Results Preoperative general data of sex, age, BMI and charlson comorbidity score of THA group(n=55) has no statistically significant difference with that of HA group. Patients treated by THA had significantly longer operation time (105.5 vs 76.7 minutes; P 0.05). The differences in hip function in favor of THA appeared to increase after the five-year follow-up, and the difference was significant in terms of the total Harris hip score (81.3 vs 73.1, P < 0.001) as well as in the dimensions of pain (38.9 vs 35.9, P=0.033), function (33.7 vs 29.2, P=0.001), absence of deformity (4.0 vs 3.9, P=0.023) and range of motion (4.6 vs 4.2, P=0.008). There was no significant differences between groups in hip dislocation rate (6.1% vs 0.0%, P=0.239). The erosion rate of hip joint in the THA group was significantly lower than that of the HA group (0.0% vs 26.5%, P=0.002). The health-related quality of life, according to EQ-5D index score, was found to be higher (0.69 vs 0.63, P= 0.001) in the THA group than the HA group after five years. Conclusion THA may be a preferred management option for active elderly patients over 75 years. The more extensive surgery of THA is not associated with higher in-hospital complication rate or mortality rate. These patients can benefit from THA in terms of hip function and quality of life. Trial registration No.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2474Test

الوصول الحر: https://doaj.org/article/4f8831e49a8c491a94d5a0fc48f1e65eTest

المؤلفون: Frede Frihagen, Marianne Comeau-Gauthier, Daniel Axelrod, Sofia Bzovsky, Rudolf Poolman, Diane Heels-Ansdell, Mohit Bhandari, Sheila Sprague, Emil Schemitsch

المصدر: Bone & Joint Open, Vol 3, Iss 8, Pp 611-617 (2022)

مصطلحات موضوعية: Femoral neck fracture, Health-related quality of life, Total hip arthroplasty, Hemiarthroplasty, displaced femoral neck fracture, total hip arthroplasty (THA), Orthopedic surgery, RD701-811

الوصف: AimsThe aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population.MethodsWe performed a post hoc exploratory analysis of a fitter cohort of patients from the HEALTH trial. Participants were aged over 50 years and had sustained a low-energy displaced femoral neck fracture (FNF). The fittest participant cohort was defined as participants aged 70 years or younger, classified as American Society of Anesthesiologists grade I or II, independent walkers prior to fracture, and living at home prior to fracture. Multilevel models were used to estimate the effect of THA versus HA on functional outcomes. In addition, a sensitivity analysis of the definition of the fittest participant cohort was performed.ResultsThere were 143 patients included in the fittest cohort. Mean age was 66 years (SD 4.5) and 103 were female (72%). No clinically relevant differences were found between the treatment groups in the primary and sensitivity analyses.ConclusionThis analysis found no differences in functional outcomes between HA and THA within two years of displaced low-energy FNF in a subgroup analysis of the fittest HEALTH patients. These findings suggest that very few patients above 50 years of age benefit in a clinically meaningful way from a THA versus a HA early after injury.Cite this article: Bone Jt Open 2022;3(8):611–617.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2633-1462Test

الوصول الحر: https://doaj.org/article/d345613455c4403a914b14b97ddfb455Test

المؤلفون: Lee, Tae Sung, Kwon, Hyuck Min, Park, Jun Young, Park, Min Cheol, Choi, Yong Seon, Park, Kwan Kyu

المصدر: Gerontology ; ISSN:1423-0003 ; Volume:70 ; Issue:6

مصطلحات موضوعية: Bipolar hemiarthroplasty, Geriatric displaced femoral-neck fracture, Peripheral nerve block

الوصف: The purpose of this study was to evaluate peripheral nerve block (PNB) effectiveness in postoperative pain management and surgical outcomes for displaced femoral-neck fracture in geriatric patients (>70 years) who underwent bipolar hemiarthroplasty (BHA).

العلاقة: https://doi.org/10.1159/000538614Test; https://pubmed.ncbi.nlm.nih.gov/38574472Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177891Test/

الإتاحة: https://doi.org/10.1159/000538614Test
https://pubmed.ncbi.nlm.nih.gov/38574472Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11177891Test/

المؤلفون: Fernando Diaz-Dilernia, MD, Agustin Garcia-Mansilla, MD, Lionel Llano, MD, Martin Buljubasich, MD, Jose Ignacio Oñativia, MD, Pablo Ariel Isidoro Slullitel, MD, Gerardo Zanotti, MD, Fernando Comba, MD, Francisco Piccaluga, MD, Martin Alejandro Buttaro, MD

المصدر: Arthroplasty Today, Vol 6, Iss 4, Pp 736-741 (2020)

مصطلحات موضوعية: Displaced femoral neck fracture, Total hip arthroplasty, Hip surgeons, Orthopaedic resident, Hip biomechanics, Orthopedic surgery, RD701-811

الوصف: Background: This study aims to analyze the ability to restore hip biomechanics in patients who undergo total hip arthroplasty for displaced femoral neck fractures operated by either hip surgeons (HSs) or orthopaedic residents (ORs). Methods: We retrospectively compared 95 patients treated by HSs (group A) with 110 patients treated by ORs (group B). Leg-length discrepancy, femoral offset (FO), center of rotation (COR), acetabular inclination, and acetabular anteversion were evaluated on postoperative radiographs using the healthy contralateral hip as control. Results: The median leg-length discrepancy was 2 mm for both groups (P = .74). The leg length was increased in 54% of the HS group and 57% of the OR group (P = .13). The median FO difference of groups A and B were 7 mm and 5.5 mm, respectively (P = .14). FO was increased in 80% of the HS group and 69% of the OR group (P = .19). Median discrepancies of the horizontal and vertical CORs were not statistically relevant, with P-values of .69 and .14, respectively. The horizontal COR was slightly medialized in 58% of the HS group and 53% of the OR group (P = .003). The vertical COR was slightly proximal in 66% of the HS group and 76% of the OR group (P = .28). The median acetabular inclination angles of groups A and B were 41° and 40°, respectively (P = .62). The median anteversion angle was 19° for both groups (P = .89). Conclusions: The horizontal COR was the only measurement with statistical significance. To conclude, ORs under supervision are as reliable as HSs to properly restore hip biomechanics in patients who undergo total hip arthroplasty for displaced femoral neck fractures.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2352344120301461Test; https://doaj.org/toc/2352-3441Test

الوصول الحر: https://doaj.org/article/1a21c4ae8f5d4e7b98edbbca124c950cTest

المؤلفون: Bordes, Maxence, Viste, Anthony, Fauvernier, Mathieu, Mercier, Marcelle, Chaudier, Philippe, Severyns, Mathieu, Fessy, Michel-Henri

المساهمون: Centre Hospitalier Lyon Sud CHU - HCL (CHLS), Hospices Civils de Lyon (HCL), Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406 ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Gustave Eiffel, Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Service de Biostatistiques Lyon, Hôpital Pierre Zobda-Quitman CHU de la Martinique, CHU de la Martinique Fort de France

المصدر: ISSN: 1877-0568 ; EISSN: 1877-0568.

مصطلحات موضوعية: Dual mobility, Uncemented stem, Displaced femoral neck fracture, Total hip arthroplasty, Hip Dislocation, Periprosthetic fracture, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph]

الوصف: International audience ; IntroductionThe choice of implant type for total hip replacement in the treatment of femoral neck fractures remains debated. Some authors advocate for the systematic use of cemented stems, while others do not use dual mobility first-line. We therefore conducted a retrospective study using a dual mobility cup (DMC) and an uncemented collared stem (UCS) in order to: (1) confirm the low dislocation rate in this indication, (2) assess other surgical complications, in particular periprosthetic fractures, (3) ensure that these benefits are maintained over time, at a minimum follow-up of 5 years and, (4) assess the rate of revision of the implants.HypothesisOur hypothesis was that the dual mobility dislocation rate for the treatment of femoral neck fractures was lower than for bipolar hemiarthroplasties or single mobility hip prostheses.Patients and methodsA retrospective study of 244 femoral neck fractures (242 patients) treated with DMC and UCS was conducted, between 2013 and 2014. The mean age was 83±10 years (60-104). The occurrence of dislocation, periprosthetic fracture, infection of the surgical site, loosening, reoperation and revision were investigated. The HOOS Joint Replacement (JR) score was collected. The cumulative incidence with mortality was used as a competing risk.ResultsThe mean follow-up was 6 years±0.5 (5-7). At the last follow-up, 108 patients (50%) had died. Twenty-three patients (9.5%) were lost to follow-up. One case of symptomatic aseptic loosening of DMC was observed. The cumulative incidence of dislocations and periprosthetic fractures at 5 years were 2% (95% CI: 0.9-5.4) and 3% (95% CI: 1.2-6), respectively. The 5-year cumulative incidence of surgical site infections was 3.5% (95% CI: 1.8-7). The cumulative incidence of reoperations at 5 years was 7% (95% CI: 4.5-11). The causes of reoperation were periprosthetic fracture (n=6), infection (n=8), postoperative hematoma (n=2) and cup malposition (n=2). The cumulative incidence of a revision at 5 years was 2.7% (95% ...

العلاقة: hal-04009327; https://hal.science/hal-04009327Test; https://hal.science/hal-04009327/documentTest; https://hal.science/hal-04009327/file/1-s2.0-S1877056821004291-am.pdfTest

الإتاحة: https://doi.org/10.1016/j.otsr.2021.103164Test
https://hal.science/hal-04009327Test
https://hal.science/hal-04009327/documentTest
https://hal.science/hal-04009327/file/1-s2.0-S1877056821004291-am.pdfTest

المؤلفون: Frede Frihagen, Marianne Comeau-Gauthier, Daniel Axelrod, Sofia Bzovsky, Rudolf Poolman, Diane Heels-Ansdell, Mohit Bhandari, Sheila Sprague, Emil Schemitsch

مصطلحات موضوعية: 12-Item Short Form Survey (SF-12), Anesthesiologists, EQ-5D scores, Femoral neck fracture, Health-related quality of life, Hemiarthroplasty, Total hip arthroplasty, displaced femoral neck fracture, functional outcomes, hip fractures, sensitivity analysis, total hip arthroplasty (THA), walkers, HEALTH Investigators

الوصف: Aims The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population. Methods We performed a post hoc exploratory analysis of a fitter cohort of patients from the HEALTH trial. Participants were aged over 50 years and had sustained a low-energy displaced femoral neck fracture (FNF). The fittest participant cohort was defined as participants aged 70 years or younger, classified as American Society of Anesthesiologists grade I or II, independent walkers prior to fracture, and living at home prior to fracture. Multilevel models were used to estimate the effect of THA versus HA on functional outcomes. In addition, a sensitivity analysis of the definition of the fittest participant cohort was performed. Results There were 143 patients included in the fittest cohort. Mean age was 66 years (SD 4.5) and 103 were female (72%). No clinically relevant differences were found between the treatment groups in the primary and sensitivity analyses. Conclusion This analysis found no differences in functional outcomes between HA and THA within two years of displaced low-energy FNF in a subgroup analysis of the fittest HEALTH patients. These findings suggest that very few patients above 50 years of age benefit in a clinically meaningful way from a THA versus a HA early after injury. Cite this article: Bone Jt Open 2022;3(8):611–617.

العلاقة: http://hdl.handle.net/10779/DRO/DU:20580534.v1Test; https://figshare.com/articles/journal_contribution/Who_if_anyone_may_benefit_from_a_total_hip_arthroplasty_after_a_displaced_femoral_neck_fracture_/20580534Test

الإتاحة: http://hdl.handle.net/10779/DRO/DU:20580534.v1Test
https://figshare.com/articles/journal_contribution/Who_if_anyone_may_benefit_from_a_total_hip_arthroplasty_after_a_displaced_femoral_neck_fracture_/20580534Test

المؤلفون: Ochi Hironori, Baba Tomonori, Homma Yasuhiro, Matsumoto Mikio, Watari Taiji, Ozaki Yu, Kobayashi Hideo, Kaneko Kazuo

المصدر: SICOT-J, Vol 3, p 56 (2017)

مصطلحات موضوعية: Displaced femoral neck fracture, Direct anterior approach, Total hip arthroplasty, Dual mobility cup, Single conventional cup, Orthopedic surgery, RD701-811

الوصف: Introduction: Although total hip arthroplasty (THA) is superior to bipolar hemiarthroplasty (BHA) for displaced femoral neck fracture in terms of hip pain, function and reoperation rate, THA has a higher rate of dislocation. The direct anterior approach (DAA) and a dual mobility cup (DMC) are associated with lower rates of dislocation. The aim of this study was to investigate the outcomes of THA compared with BHA, and in those patients who had a THA we investigated those with a DMC (DMC-THA) and compared them with those had a single conventional cup (Single cup-THA). Materials: A total of 89 patients living independently were included between 2009 and 2015. We assessed patient characteristics, peri- and post-operative outcomes, walking ability and one-year mortality. Adjusted odds ratios (Adjusted ORs) were estimated for decrease of walking ability and one-year mortality using a logistic regression model with adjustment for potential confounders such as age, neuromuscular diseases with weakness, duration of surgery, perioperative blood loss and preoperative walking ability. Results: BHA (20 patients) versus THA (69 patients): There was no significant difference in the walking ability in either group. Multivariable logistic regression analysis demonstrated a significant association with one-year mortality in both groups [THA Adjusted ORs 0.088 (95% CI 0.0007–0.69); p = 0.020]. Single cup-THA (36 patients) versus DMC-THA (33 patients): The DMC-THA group had significantly greater age and more patients with neuromuscular diseases with weakness compared with the Single cup-THA group. Multivariable logistic regression analysis demonstrated no significant difference in the decrease of walking ability and in the one-year mortality between the groups. There were no post operative dislocations in any group. Discussion: THA via the DAA is one of the best treatments for displaced femoral neck fracture with a low risk of dislocation. THA via the DAA with a DMC is a safe and effective treatment for the patients with a high ...

العلاقة: https://doi.org/10.1051/sicotj/2017048Test; https://doaj.org/toc/2426-8887Test; https://doaj.org/article/e79d01b3d78e41d7a4ab46ac971b87c5Test

الإتاحة: https://doi.org/10.1051/sicotj/2017048Test
https://doaj.org/article/e79d01b3d78e41d7a4ab46ac971b87c5Test

المؤلفون: Andersen Michelle F., Jakobsen Thomas, Bensen Anne S., Krarup Niels

المصدر: SICOT-J, Vol 1, p 26 (2015)

مصطلحات موضوعية: Displaced femoral neck fracture, Total hip arthroplasty, Cemented, Uncemented, Reoperation, Orthopedic surgery, RD701-811

الوصف: Introduction: Acute displaced femoral neck fractures are often treated with cemented hemiarthroplasty (HA). There is increasing evidence that total hip arthroplasty (THA) may be a better alternative, but the degree to which the fixation of the femoral stem used affects the outcome is not fully known. The aim of this study is to compare rates of operative complications and implant survival following THA treatment of displaced femoral neck fractures with either a cemented or an uncemented femoral stem. Methods: The study consists of two groups of patients (N = 334), who were treated for a displaced femoral neck fracture with THA at the Regional Hospital of Viborg during 2007–2012. The first group (50.9%) had uncemented (Corail®) stem while the second group (49.1%) had cemented (Exeter®) stem implanted. Nearly all patients had uncemented dual mobility cup (Saturne®) as acetabular component and were followed up to three months postoperatively. Data regarding rates of implant survival and operative complications were obtained by retrospective review of medical records. Results: We found a statistically significant difference regarding rates of postoperative reoperation with 1.2% (95% CI 0.005–0.03) for cemented and 5.9% (95% CI 0.02–0.09) for uncemented stem (p = 0.02). The main causes for reoperation were peri-prosthetic fractures and deep infections. There was no difference regarding dislocation or peroperative complications. Rates of dislocation were 4.3% (95% CI 0.012–0.07) for cemented and 3.5% (95% CI 0.008–0.06) for uncemented stem (p = 0.72). Rates of peroperative complications were 6.1% (95% CI 0.024–0.1) for cemented and 8.2% (95% CI 0.04–0.12) for uncemented stem (p = 0.1). Discussion: Our results indicate that cemented femoral stem is superior to cementless when rates of reoperation are compared.

العلاقة: http://dx.doi.org/10.1051/sicotj/2015028Test; https://doaj.org/toc/2426-8887Test; https://doaj.org/article/d5021edb929c431ea262e24c3289b5f8Test

الإتاحة: https://doi.org/10.1051/sicotj/2015028Test
https://doaj.org/article/d5021edb929c431ea262e24c3289b5f8Test

المؤلفون: Ginsel, Bastiaan, Crawford, Ross W., Whitehouse, Sarah L., Taher, Ahmad

المصدر: International Society for Technology in Arthroplasty (ISTA 2013)

مصطلحات موضوعية: ASA classification, cemented prosthesis, displaced femoral neck fracture, in-hospital mortality, neck of femur fracture

الوصف: Aim This prospective cohort study investigated whether the use of preoperative anticoagulants is an independent risk factor for the outcomes of surgical treatment of patients with a neck of femur fracture. Methods Data was obtained from a prospectively collected database. All patients admitted for a neck of femur fracture between Nov 2010 and Oct 2011 were included. This resulted in three hundred twenty-eight patients with 330 neck of femur fractures. Four groups were defined; patients preoperatively (i) on aspirin (n = 105); (ii) on clopidogrel (n = 28); (iii) on warfarin (n = 30), and; (iv) without any anticoagulation history (n = 167, the control group). The non-warfarin group included the aspirin group, clopidogrel group and the control group. Primary outcome was the in-hospital mortality. Secondary outcomes were the postoperative complications, return to theatre and length of stay. Results Thirteen in-hospital deaths were identified, 4 deaths in the aspirin group, 1 death in the clopidogrel group, 2 deaths in the warfarin group and 6 deaths in the control group. No significant difference in the mortality rates was found between the different groups. Also in the secondary outcomes, no significant difference was found between the four groups. A trend to a higher wound complication rate for the warfarin group was detected. Conclusion The use of clopidrogel or aspirin pre operatively is not an influence on short term patient outcome for patients with a neck of femur fracture. Surgical procedures should not be delayed to reverse their influence.

وصف الملف: application/pdf

العلاقة: https://eprints.qut.edu.au/75537/1/75537.pdfTest; http://www.bjjprocs.boneandjoint.org.uk/content/95-B/SUPP_34/324.abstractTest; Ginsel, Bastiaan, Crawford, Ross W., Whitehouse, Sarah L., & Taher, Ahmad (2013) In-hospital mortality rates after a cemented femoral component for displaced neck of femur fractures. In International Society for Technology in Arthroplasty (ISTA 2013), 2013-10-16 - 2013-10-19.; https://eprints.qut.edu.au/75537Test/; Institute of Health and Biomedical Innovation; Science & Engineering Faculty; Australian Research Centre for Aerospace Automation

الإتاحة: https://eprints.qut.edu.au/75537Test/