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- Rogmark, Cecilia, et al.
(författare)
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Orthopaedic treatment of displaced femoral neck fractures in elderly patients
- 2005
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 27:18-19, s. 1143-1149
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Tidskriftsartikel (refereegranskat)abstract
- Purpose and method: A review article concerning orthopaedic treatment and rehabilitation of displaced femoral neck fractures, focusing on evidence-based knowledge. Results: Properly performed randomized controlled studies comparing internal fixation and primary arthroplasty provides the best basis to decide which method should be used. During the last decade, several such studies have been published, in addition to a few earlier works. After internal fixation with pins, screws or sliding hip screw and plate, the failure rate was 21-57% and re-operations were performed in 14-53% of all the cases. In the studies using THA, the failure rate was 4-11% and the re-operation rate 2-8%. The corresponding numbers for hemi-arthroplasty were 3-23% and 0-24%. A primary arthroplasty tends to result in better function and less pain during the rehabilitation period. Conclusion: With support in evidence-based literature, an elderly patient with displaced femoral neck fracture should be treated with a primary arthroplasty. If the individual is healthy, active and mentally intact, a total hip arthroplasty should be performed, otherwise a hemi-arthroplasty. This rationale ensures fewer failures and re-operations, as well as better function and less pain during the rehabilitation.
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- Rogmark, Cecilia, et al.
(författare)
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Primary hemiarthroplasty in old patients with displaced femoral neck fracture: a 1-year follow-up of 103 patients aged 80 years or more
- 2002
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 1745-3682 .- 0001-6470. ; 73:6, s. 605-610
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Tidskriftsartikel (refereegranskat)abstract
- 103 patients with displaced femoral neck fractures (Garden 3-4) treated with primary hemiarthroplasty in the Department of Orthopedics, Malmö University Hospital, Sweden 1998-1999 were followed in a prospective, consecutive study for 1 year. Inclusion criteria were age of at least 80 years, signs of mental changes and/or residence in an institution. The control group consisted of 69 patients with internal fixation (Hansson hook pins). The arthroplasty group required more blood transfusions, a longer operation and had more superficial infections. No differences were detected as regards other complications, length of hospital stay, in-hospital mortality or ability to return home. The 1-year mortality rates were similar in the arthroplasty (29/103) and control groups (28/69). Within 1 year, we found a lower failure rate in the arthroplasty group (6/103) than in the control group (18/69). In the arthroplasty group, 2/103 had dislocations. Of the surviving arthroplasty patients at 12 months, 31/74 could walk as well as before the fracture and 55/74 had no pain. We recommend primary hemiarthroplasty for demented and/or institutionalized patients over 80 years with displaced femoral neck fractures.
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