Outcomes of nondisplaced intracapsular femoral neck fractures with internal screw fixation in elderly patients: a systematic review
| Autor: | Pablo A. Slullitel, Juan M Gonzales Viezcas, Prem N. Ramkumar, Valeria Vietto, Martin Buttaro, Fernando Diaz Dilernia, Ignacio J. Oñativia, Nicolas S. Piuzzi |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Bone Screws Femoral Neck Fractures Screw fixation 03 medical and health sciences Fracture Fixation Internal 0302 clinical medicine Fracture fixation Medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Aged Aged 80 and over 030222 orthopedics business.industry Age Factors Middle Aged Surgery Radiography Hip arthroplasty Treatment Outcome Female business |
| Zdroj: | Hip international : the journal of clinical and experimental research on hip pathology and therapy. 28(1) |
| ISSN: | 1724-6067 |
| Popis: | Introduction: Although the preferred treatment for displaced femoral neck fractures in the elderly is hip arthroplasty, the treatment for impacted or undisplaced femoral neck fractures (UFNF) is still a subject of controversy. Our purpose was to systematically review studies of elderly patients with UFNF treated with internal fixation using screws: (i) what is the reported mortality; (ii) what is the reoperation rate; (iii) what are the clinical and radiological outcomes; and (iv) what is the methodological quality of the included studies? Methods: This systematic review was performed through a search of PubMed and the Cochrane database using a structured search algorithm including studies enrolling patients older than 60 years old, with UFNF treated with internal fixation using screws. Our literature search returned 950 studies and 11 were selected for final abstraction. Results: 6 studies reported mortality rate. At 1-year follow-up mortality was reported by 3 studies: 18.8%; 22%, and 19%. At 5 years, 1 study reported mortality rate of 42%. Overall reoperation rate was reported by 9 studies and ranged from 8%-19%, while conversion to hip arthroplasty was performed in the range between 8% and 16% according to 6 studies. Conclusions: Internal fixation with cannulated screws for UFNF in the elderly is a valuable option, although it has substantial reoperation and mortality rates. Further prospective high-quality, randomised controlled trials are required to establish the optimal approach for the treatment of UFNF. |
| Databáze: | OpenAIRE |
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