| Abstrakt: |
Objective. Total hip replacement is one of the most successful surgeries in recent years. The increase in total hip replacement procedures for the extension of indications, from primary/secondary arthrosis to medial femoral neck fractures, is associated with an increase in the average age of the population leading to an inevitable increase in complications, such as periprosthetic proximal femoral fractures (PPFF), even if rare. However, the importance of this complication lies in the high mortality, poor outcomes, and often incomplete recovery. The objective of our study is to investigate whether time to surgery was a prognostic element in the treatment of these fractures, considering that these patients are often fragile and will require timely treatment like patients who fall within the native hip fracture protocol. Methods. 112 patients suffering from PPFF, classified with x ray according to Vancouver Classification were selected from 2007 to 2022 in two different hospitals in Rome. The minimum follow-up was 1 year and mortality, post-operative complications, and outcome were assessed in relation to time to surgery. Results. There was a significant correlation between mortality and time to surgery and each hour of delay to surgery the risk of mortality increased by 2%. Moreover, a statistical significance was found between the inability to restore walking ability in the early postoperative period and one year mortality. Conclusions. Patients with PPFF should be surgically treated with the same timing of patients with femoral neck fracture, in order to improve clinical outcomes, reduce post operative complications, restore walking ability, and reduce mortality. [ABSTRACT FROM AUTHOR] |
