Eight-year outcome associated with clinical options in the management of femoral neck fractures.
This study involved a review of the medical records of 367 patients treated surgically after femoral neck fracture. Linkage of these records with claims files from the Health Care Financing Administration allowed as many as 8 years of followup to analyze the rates of hospital readmission rates for revision, other postoperative complications and mortality. The results revealed: (1) a significantly higher revision rate was associated with internal fixation for the treatment of displaced femoral neck fractures in patients older than 80 years of age; no differences in revision rates were seen between internal fixation or hemiarthroplasty for the treatment of nondisplaced femoral neck fractures in this patient age group; (2) no differences in revision rates were found between internal fixation or hemiarthroplasty for the treatment of displaced femoral neck fractures in patients between the ages of 65 to 80 years; (3) a significantly higher mortality rate was associated with internal fixation than hemiarthroplasty for patients who were between the ages of 65 and 80 years; and (4) no differences in medical or surgical complications, revision rates, or other outcomes were found between unipolar and bipolar prostheses, or between anterior and posterior surgical approaches for hemiarthroplasty in patients who were age 65 years or older.
Hudson
J I
JI
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
Kenzora
J E
JE
Hebel
J R
JR
Gardner
J F
JF
Scherlis
L
L
Epstein
R S
RS
Magaziner
J S
JS
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D014487:Centers for Medicare and Medicaid Services, U.S.; D015331:Cohort Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008498:Medical Record Linkage; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D011183:Postoperative Complications; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States