Evidence summary: systematic review of surgical treatments for geriatric hip fractures
| Autor: | Mary L Forte, Robert L. Kane, Marc F. Swiontkowski, Siddharth Joglekar, Mary Butler |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
MEDLINE Femoral Neck Fractures law.invention Quality of life Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Aged Aged 80 and over Hip fracture business.industry Hip Fractures Age Factors General Medicine Evidence-based medicine medicine.disease Systematic review Treatment Outcome Physical therapy Surgery Observational study business |
| Zdroj: | The Journal of bone and joint surgery. American volume. 93(12) |
| ISSN: | 1535-1386 |
| Popis: | Background: There is a growing body of literature on surgical treatments for elderly patients with a hip fracture and the effects of various surgical procedures on complications and postoperative outcomes. No single review has previously summarizedtheliteratureontheeffectsofsurgicalproceduresonoutcomesaftertreatmentacrossalltypesofhipfractures. We conducted a comprehensive systematic literature review to organize the clinical evidence for patient-centered outcomes across all types of geriatric hip fractures. Methods: We searched MEDLINE, the Cochrane Database of Systematic Reviews, Scirus, and ClinicalTrials.gov for randomized clinical trials and observational studies published between 1985 and 2008. We also manually searched reference lists from relevant systematic reviews. Results: We found eighty-one articles representing seventy-six unique, randomized, controlled trials, including thirty-five on femoral neck fractures, forty on intertrochanteric fractures, and one on subtrochanteric fractures. Nine observational studies addressed the link between patient characteristics and outcome variables by fracture type. Age, sex, prefracture functioning, and cognitive impairment are related to mortality and functional outcomes. Fracture type does not appear to be independently related to patient outcomes. Mortality, pain, function, and quality of life did not differ by surgical implant class,orbyimplantswithinaclass.Neithertherandomizedcontrolledtrialsnortheobservationalliteratureincludethefull complement of potential covariates that can impact treatment outcomes after treatment. Conclusions: The broader questions about the relationship of patient factors, fracture type, and specific treatments to the outcomes of mortality, functional status, and quality of life cannot be addressed with the existing literature. Research should include comprehensive conceptual models that capture complete sets of important independent variables. Studies of musculoskeletal outcomes, including hip fracture, require well-defined patient groups and consistent use of validated outcome measures. Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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