T Kostuj1, R Smektala, U Schulze-Raestrup, C Müller-Mai. 1. Abteilung für Unfallchirurgie, Chirurgische Universitätsklinik, Knappschaftskrankenhaus Bochum-Langendreer, Universitätsklinik, Ruhr-Universität-Bochum, Bochum, Deutschland. tanja.kostuj@friedrichsheim.de
Abstract
BACKGROUND: The current S2 guideline recommends treatment of a femoral neck fracture within the first 24 h; this becomes evident by the significant rise in general and early surgical complications, when the surgical treatment was delayed for more than 48 h. The influence of different surgical procedures was investigated. PATIENTS UND METHODS: A total of 22,566 records from the external Quality Assurance Program in North Rhine-Westphalia for treatment of femoral neck fractures in 2004/2005 (BQS specification 7.0 and 8.0) were risk-adjusted and evaluated. RESULTS: Surgery was performed within 48 h in 83.9% of the patients. A significant rise in general and early surgical complications was registered when the surgical treatment was delayed for more than 48 h. Mortality and general complications were significantly lower for percutaneous screw fixation. All kinds of joint replacement show significantly higher general and surgical complications. CONCLUSION: The analyzed data support the rating of femoral neck fracture as requiring the intervention of urgent early surgery, as stated in the guideline. Percutaneous screw fixation can be considered for immobile and multimorbid patients with undislocated fractures. Advantages of total hip replacement compared to hemiarthroplasty cannot be supported by the QS-NRW data.
BACKGROUND: The current S2 guideline recommends treatment of a femoral neck fracture within the first 24 h; this becomes evident by the significant rise in general and early surgical complications, when the surgical treatment was delayed for more than 48 h. The influence of different surgical procedures was investigated. PATIENTS UND METHODS: A total of 22,566 records from the external Quality Assurance Program in North Rhine-Westphalia for treatment of femoral neck fractures in 2004/2005 (BQS specification 7.0 and 8.0) were risk-adjusted and evaluated. RESULTS: Surgery was performed within 48 h in 83.9% of the patients. A significant rise in general and early surgical complications was registered when the surgical treatment was delayed for more than 48 h. Mortality and general complications were significantly lower for percutaneous screw fixation. All kinds of joint replacement show significantly higher general and surgical complications. CONCLUSION: The analyzed data support the rating of femoral neck fracture as requiring the intervention of urgent early surgery, as stated in the guideline. Percutaneous screw fixation can be considered for immobile and multimorbid patients with undislocated fractures. Advantages of total hip replacement compared to hemiarthroplasty cannot be supported by the QS-NRW data.
Authors: Ernst Sendtner; Tobias Renkawitz; Peter Kramny; Michael Wenzl; Joachim Grifka Journal: Dtsch Arztebl Int Date: 2010-06-11 Impact factor: 5.594
Authors: R Smektala; S Hahn; P Schräder; F Bonnaire; U Schulze Raestrup; H Siebert; B Fischer; O Boy Journal: Unfallchirurg Date: 2010-04 Impact factor: 1.000
Authors: Jan-Erik Gjertsen; Tarjei Vinje; Stein Atle Lie; Lars B Engesaeter; Leif Ivar Havelin; Ove Furnes; Jonas M Fevang Journal: Acta Orthop Date: 2008-10 Impact factor: 3.717
Authors: Ernst J Müller; Ingeborg Gerstorfer; Peter Dovjak; Bernhard Iglseder; Georg Pinter; Walter Müller; Katharina Pils; Peter Mikosch; Michaela Zmaritz; Monique Weissenberger-Leduc; Markus Gosch; Heinrich W Thaler Journal: Wien Med Wochenschr Date: 2013-11-08
Authors: Franz Müller; Michael Galler; Tanja Kottmann; Michael Zellner; Christian Bäuml; Bernd Füchtmeier Journal: Unfallchirurg Date: 2018-07 Impact factor: 1.000
Authors: Franz Müller; Michael Galler; Michael Zellner; Christian Bäuml; Stephan Grechenig; Tanja Kottmann; Bernd Füchtmeier Journal: Geriatr Orthop Surg Rehabil Date: 2019-01-04