Predictors of early failure of fixation in the treatment of displaced subcapital hip fractures.
J Orthop Trauma
; 12(4): 230-4, 1998 May.
Article
en En
| MEDLINE
| ID: mdl-9619456
ABSTRACT
OBJECTIVE:
To examine predictors of fixation failure in the treatment of displaced subcapital hip fractures.DESIGN:
Retrospective study.METHODS:
All patients aged sixty-five years and older discharged from a large teaching hospital after treatment for displaced subcapital fracture between April 1, 1989 and February 29, 1995 were identified (n = 344). Of these, 108 patients treated with internal fixation became the study group. Clinical information included demographics, implant, comorbidity, complications, mortality, surgeon' s assessment of reduction, and need for revision. Preoperative x-ray information Garden grade, Singh Index, Pauwel's angle, medial neck and femoral shaft cortex width, and displacement of fracture fragments. Postoperative Quality of reduction, a visible gap or step, evidence of union, fracture collapse, and failure.RESULTS:
The failure rate was 31 percent. The two most important predictors were varus reduction and perceived difficulty in achieving reduction. If the patient had a varus reduction or the surgeon had difficulty achieving a satisfactory reduction, fixation was 4.3 times more likely to fail (p = 0.007). If the patient had a varus reduction and reduction was difficult, fixation was 13.6 times more likely to fail (p = 0.04). Under this latter scenario, 75 percent of the fixations failed.CONCLUSION:
In a fracture of the neck of the femur, if difficulty is encountered in obtaining a closed reduction or there is residual varus angulation, the chance of subsequent fixation failure is high. Hemiarthroplasty may be considered in these cases.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Fracturas del Cuello Femoral
/
Fijación Interna de Fracturas
/
Luxación de la Cadera
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Orthop Trauma
Asunto de la revista:
ORTOPEDIA
/
TRAUMATOLOGIA
Año:
1998
Tipo del documento:
Article
País de afiliación:
Canadá