Hip fractures: femoral neck versus trochanteric fractures, baseline characteristics and clinical outcomes.

Abstract

Aims: The aim of this study was to assess differences in the clinical profile and baseline characteristics between patients with femoral neck fracture (FNF) and trochanteric fracture (TF). The secondary aim was to explore potential differences in clinical outcomes and mortality.

Methods: A prospective hip fracture database (FAMMI) was used to obtain data for this observational cohort study. Patients with hip fracture surgery between January 2018 and February 2021 who were aged older than 70 years were prospectively included. Differences between patients with FNF and TF were evaluated by univariable logistic regression. A multivariable analysis was performed to analyze the relationship between type of fracture and mortality, adjusting for potential confounders.

Results: In total, 2,089 patients were analyzed, of whom 1,233 (59%) had FNF and 856 (41%) had TF. Patients with TF were older, more often female, had a higher rate of chronic obstructive pulmonary disease and dementia, and had a lower Katz Index of Independence in activities of daily living score. Patients with TF had a lower rate of clinical complications such as delirium, pneumonia, reoperation, or wound infections. No differences in 30-day and one-year mortality were observed, also after multivariable correction.

Conclusion: Based on this study, elderly patients with TF exhibit a comparatively inferior baseline status in comparison to patients with FNF. However, patients with TF have lower incidence of postoperative complications. No differences in 30-day and one-year mortality rates were observed between patients with the two types of proximal femoral fractures.