Prosthesis or osteosynthesis for the treatment of a pathological hip fracture? A nationwide registry-based cohort study
| Autor: | Margareta Hedström, Panagiotis Tsagkozis, Jessica Ehne, Rikard Wedin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
musculoskeletal diseases medicine.medical_specialty medicine.medical_treatment Pain Prosthesis Diseases of the musculoskeletal system 03 medical and health sciences 0302 clinical medicine Pathological Health care Medicine Function RC254-282 Hip fracture Osteosynthesis Hip business.industry General surgery Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease University hospital 030104 developmental biology Fracture Oncology RC925-935 030220 oncology & carcinogenesis Ambulatory Surgery business Cohort study Research Paper |
| Zdroj: | Journal of Bone Oncology Journal of Bone Oncology, Vol 29, Iss, Pp 100376-(2021) |
| ISSN: | 2212-1366 |
| Popis: | Highlights • Prostheses result in lower pain than osteosyntheses in pathological hip fractures. • Surgeons in sarcoma centers generally use prostheses for pathological hip fractures. • Both methods use similar healthcare resources and effectively restore ambulation. Aims How endoprosthetic replacement compares to osteosynthesis in the treatment of pathologic hip fractures as far as functional outcome and use of healthcare resources is concerned remains largely unknown. We aimed to investigate this in a nationwide registry. Methods We analyzed the functional outcome after surgery for a pathological fracture of the hip in terms of post-operative pain and ambulatory capacity. The preferred surgical method depending on the level of the treating unit was also examined. Furthermore, we documented the length of hospital stay and the patterns of discharge and compared them between these two methods. Results Patients operated with an endoprosthesis reported significantly lower pain at follow-up. Both methods (endoprosthetic replacement and osteosynthesis) were equally effective in restoring the ambulatory capacity and demanded a similar length of stay in hospital. Orthopaedic surgeons working in hospitals with dedicated sarcoma teams were more likely to use a prosthesis rather than osteosynthesis, when compared to surgeons working at other university hospitals or emergency hospitals. Conclusion Endoprosthetic replacement results in a better functional outcome in terms of post-operative pain without consuming more healthcare resources. Orthopaedic surgeons working in hospitals with sarcoma centers are more likely to use prostheses as compared to surgeons working at hospitals where dedicated musculoskeletal oncology teams are not available. |
| Databáze: | OpenAIRE |
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