TY - JOUR
T1 - Displaced Versus Nondisplaced Femoral Neck Fractures
T2 - Is Arthroplasty the Answer for Both?
AU - Arthroplasty for Hip Fracture Consortium
AU - Frandsen, Jeffrey J.
AU - Rainey, Joshua P.
AU - DeKeyser, Graham J.
AU - Blackburn, Brenna E.
AU - Cichos, Kyle H.
AU - Patel, Stuti S.
AU - Cao, Amanda Q.
AU - Jordan, Eric M.
AU - Sing, David
AU - Frandsen, Jeff J.
AU - Sauer, Madeline A.
AU - Ewing, Michael A.
AU - Chen, Antonia F.
AU - Hansen, Erik N.
AU - Gililland, Jeremy M.
AU - O'Malley, Michael J.
AU - McGwin, Gerald
AU - Mueller, Joshua M.
AU - Mears, Simon C.
AU - Bhanat, Eldrin
AU - Stayer, George W.
AU - Almand, Mariegene E.
AU - Bergin, Patrick F.
AU - Yener, Ugur
AU - Stambough, Jeffrey B.
AU - Stronach, Benjamin M.
AU - Crist, Brett D.
AU - Keeney, James A.
AU - Shah, Vivek M.
AU - Lange, Jeffrey K.
AU - Olsen, Adam S.
AU - Melnic, Christopher M.
AU - Boyd, Brandon
AU - Ghanem, Elie S.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Traditionally, nondisplaced geriatric femoral neck fractures (FNFs) have undergone operative fixation, while displaced geriatric FNFs have undergone hip arthroplasty. The purpose of this study was to evaluate differences between outcomes in patients with nondisplaced (Garden I and II) fractures and displaced (Garden III and IV) fractures that were treated with arthroplasty. Methods: This was a retrospective review of patients who had a minimum of 1 year follow-up from nine academic medical centers who underwent arthroplasty for FNFs between 2010 and 2020. Chi-square, Fisher's Exact, and t-tests were used to compare demographics and outcomes between patients who had a displaced fracture and those who had a nondisplaced fracture. We included 1,620 patients, with 131 in the nondisplaced cohort and 1,497 in the displaced cohort. The mean follow-up in the study was 26.4 months. Both groups were similar in terms of demographic variables. Results: At 1-year follow-up, the overall reoperation rate was 7% and was not different between patients who had nondisplaced compared to displaced FNFs who underwent arthroplasty. Heterotopic ossification (HO) was significantly higher in displaced (23.6%) versus nondisplaced fractures (11.7%) (P = .0021). Operative times and blood loss were higher in nondisplaced than displaced fractures that underwent arthroplasty. Conclusion: Hip arthroplasty is an excellent treatment option for nondisplaced and displaced geriatric FNFs with relatively low and similar reoperation rates at 1 year. Compared to previously published reoperation rates of internal fixation of nondisplaced FNFs, hip arthroplasty is a reasonable treatment option for nondisplaced FNFs to potentially decrease reoperations in a frail patient population.
AB - Background: Traditionally, nondisplaced geriatric femoral neck fractures (FNFs) have undergone operative fixation, while displaced geriatric FNFs have undergone hip arthroplasty. The purpose of this study was to evaluate differences between outcomes in patients with nondisplaced (Garden I and II) fractures and displaced (Garden III and IV) fractures that were treated with arthroplasty. Methods: This was a retrospective review of patients who had a minimum of 1 year follow-up from nine academic medical centers who underwent arthroplasty for FNFs between 2010 and 2020. Chi-square, Fisher's Exact, and t-tests were used to compare demographics and outcomes between patients who had a displaced fracture and those who had a nondisplaced fracture. We included 1,620 patients, with 131 in the nondisplaced cohort and 1,497 in the displaced cohort. The mean follow-up in the study was 26.4 months. Both groups were similar in terms of demographic variables. Results: At 1-year follow-up, the overall reoperation rate was 7% and was not different between patients who had nondisplaced compared to displaced FNFs who underwent arthroplasty. Heterotopic ossification (HO) was significantly higher in displaced (23.6%) versus nondisplaced fractures (11.7%) (P = .0021). Operative times and blood loss were higher in nondisplaced than displaced fractures that underwent arthroplasty. Conclusion: Hip arthroplasty is an excellent treatment option for nondisplaced and displaced geriatric FNFs with relatively low and similar reoperation rates at 1 year. Compared to previously published reoperation rates of internal fixation of nondisplaced FNFs, hip arthroplasty is a reasonable treatment option for nondisplaced FNFs to potentially decrease reoperations in a frail patient population.
KW - femoral neck fracture
KW - geriatric hip fracture
KW - hemiarthroplasty
KW - open reduction internal fixation
KW - total hip arthroplasty
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U2 - 10.1016/j.arth.2023.04.010
DO - 10.1016/j.arth.2023.04.010
M3 - Article
C2 - 37075907
AN - SCOPUS:85159044027
SN - 0883-5403
VL - 38
SP - S284-S288
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 7
ER -