title: The rate of contralateral proximal femoral fracture following closed reduction and percutaneous pinning compared with arthroplasty for the treatment of femoral neck fractures.
abstract: BACKGROUND
  As the population ages, the number of proximal femoral fractures seen each year is expected to increase. Subsequent contralateral hip fractures have been reported to occur in as many as 11.8% of patients after surgical fixation of the initial fracture, but it is unknown if this rate is similar among patients managed with different surgical procedures.
  
  
  METHODS
  A retrospective comparative study was performed at a single institution at which electronic medical records and digital radiographs were reviewed for 1177 patients who underwent closed reduction and percutaneous pinning or arthroplasty for the treatment of a proximal femoral fracture. For the primary outcome of subsequent fracture, logistic regression analysis was applied.
  
  
  RESULTS
  Four hundred and ninety-five patients were managed with closed reduction and percutaneous pinning, and 682 were managed with arthroplasty. Patients who underwent closed reduction and percutaneous pinning were two times more likely to have a subsequent contralateral femoral fracture in comparison with those who underwent arthroplasty, with contralateral fracture rates of 10.10% for the closed reduction and percutaneous pinning group and 5.57% for the arthroplasty group (p = 0.0035).
  
  
  CONCLUSIONS
  Patients undergoing closed reduction and percutaneous pinning as the initial treatment for a hip fracture had an increased risk of a subsequent contralateral hip fracture in comparison with those undergoing arthroplasty, after controlling for patient characteristics.
authors.affiliation: Department of Orthopaedics, Scott & White Healthcare, 2401 South 31st Street, Temple, TX 76508, USA. csouder@swmail.sw.org
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Souder
authors.forename: Michael L
authors.initials: ML
authors.lastname: Brennan
authors.forename: Kindyle Losey
authors.initials: KL
authors.lastname: Brennan
authors.forename: Juhee
authors.initials: J
authors.lastname: Song
authors.forename: Johnathan
authors.initials: J
authors.lastname: Williams
authors.forename: Christopher
authors.initials: C
authors.lastname: Chaput
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012044:Regression Analysis; D012189:Retrospective Studies