与髋部骨折患者相比,接受老年骨科检查和快速手术的原发性和假体周围股骨骨折患者更少。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-03-01 Epub Date: 2023-09-18 DOI:10.1177/11207000231198459
Muhamed M Farhan-Alanie, Sam C Jonas, Daniel Gallacher, Michael R Whitehouse, Tim Js Chesser
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引用次数: 0

摘要

简介这项回顾性对比观察队列研究旨在评估股骨原发性骨折和股骨假体周围骨折的流行病学,并确定与髋部骨折相比,股骨原发性骨折和股骨假体周围骨折在处理上是否存在差异:利用医院数据库对2016年7月至2018年6月期间因股骨原发性骨折或假体周围骨折入院的所有60岁以上患者进行识别。结果与同期国家髋部骨折数据库数据进行比较:确定了58例股骨原发性骨折、87例假体周围骨折和1032例髋部骨折。(在股骨原发性骨折和假体周围骨折中,分别有79%(46/58)和76/87(89%)的患者接受了手术治疗。进行手术的比例(P 0.0001)。24/58(41%)和48/87(55%)例原发性骨折和假体周围骨折接受了骨科医师的复查,而髋部骨折的复查率为1017/1032(99%)(P 0.0001)。股骨原发性骨折、假体周围骨折和髋部骨折患者的一年死亡率分别为35%、20%和26%。股骨原发性骨折患者的Cox比例危险比高于髋部骨折患者(1.75;95% CI,1.12-2.73):这项研究表明,与髋部骨折相比,其他股骨骨折和假体周围骨折的治疗存在巨大差异,特别是手术时间和老年骨科医师的复查。这可能导致股骨原发性骨折患者的死亡率相对较高。将BPT扩展至整个股骨可能会改善治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fewer native and periprosthetic femoral fracture patients receive an orthogeriatric review and expedited surgery compared to hip fracture patients.

Introduction: Disproportionate emphasis has been attributed to hip fracture over other femoral fractures through implementation of Best Practice Tariff (BPT).This retrospective comparative observational cohort study aimed to evaluate the epidemiology of native and periprosthetic femoral fractures and establish any disparities in their management relative to hip fractures.

Methods: All patients ⩾60 years admitted with a native or periprosthetic femoral fracture during July 2016-June 2018 were identified using our hospital database. Results were compared to National Hip Fracture Database data over the same period.

Results: 58 native femoral, 87 periprosthetic and 1032 hip fractures were identified. (46/58) 79% and 76/87 (89%) of native and periprosthetic femoral fractures were managed operatively. Surgery was performed <36 hours for 34/46 (74%) of native femoral and 33/76 (43%) of periprosthetic fractures compared to 826/1032 (80%) for hips. Median time to surgery was longer in periprosthetic femoral than hip fracture patients (44.7 vs. 21.6 hours; p< 0.0001). Orthogeriatrician review occurred in 24/58 (41%) and 48/87 (55%) of native and periprosthetic fractures compared to 1017/1032 (99%) for hips (p< 0.0001). One year mortality was 35%, 20% and 26% for native femoral, periprosthetic and hip fracture patients. Cox proportional hazard ratio was higher for native femoral than hip fracture patients (1.75; 95% CI, 1.12-2.73).

Conclusions: This study demonstrates large disparities in management of other femoral and periprosthetic fractures compared to hip fractures, specifically time to surgery and orthogeriatrician review. This may have resulted in the comparatively higher mortality rate of native femoral fracture patients. Expansion of the BPT to include the whole femur is likely to improve outcomes.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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