AIM: The current publication deals with surgically treated medial and lateral femoral neck fracture of patients aged 60 and older. MATERIAL/ METHODS: All patients were evaluated who received operative treatment between day of trauma and day 14 after trauma. Therefore, 30,254 patients (77,44%) were included. All early complications observed during hospital treatment were recorded as general and special complications, and we calculated whether the day of operation influenced the occurrence of early complications. Statistically significant differences were gained for revision operations. RESULTS: If the primary operation was performed on days 2 to 3 or 4 to 5 after trauma, fewer revisions necessary. Similar results were gained for revisions due to seroma and haematoma or postoperative bleeding. In these cases, fewer revision operations were performed when primary treatment was achieved on day 2 or 3. CONCLUSIONS: From the data presented, it is postulated that early complications provide no decisive reason for treating femoral neck fracture as an emergency. However, considering late complications such as the rate of femoral head necrosis, treatment for retaining the femoral head should be performed as early as possible. German guidelines suggest early but not emergency treatment in case of operations not saving the femoral head. Emergency operation within 6 h is not mandatory.
AIM: The current publication deals with surgically treated medial and lateral femoral neck fracture of patients aged 60 and older. MATERIAL/ METHODS: All patients were evaluated who received operative treatment between day of trauma and day 14 after trauma. Therefore, 30,254 patients (77,44%) were included. All early complications observed during hospital treatment were recorded as general and special complications, and we calculated whether the day of operation influenced the occurrence of early complications. Statistically significant differences were gained for revision operations. RESULTS: If the primary operation was performed on days 2 to 3 or 4 to 5 after trauma, fewer revisions necessary. Similar results were gained for revisions due to seroma and haematoma or postoperative bleeding. In these cases, fewer revision operations were performed when primary treatment was achieved on day 2 or 3. CONCLUSIONS: From the data presented, it is postulated that early complications provide no decisive reason for treating femoral neck fracture as an emergency. However, considering late complications such as the rate of femoral head necrosis, treatment for retaining the femoral head should be performed as early as possible. German guidelines suggest early but not emergency treatment in case of operations not saving the femoral head. Emergency operation within 6 h is not mandatory.
Authors: Franz Müller; Michael Galler; Tanja Kottmann; Michael Zellner; Christian Bäuml; Bernd Füchtmeier Journal: Unfallchirurg Date: 2018-07 Impact factor: 1.000