Open reduction internal fixation versus hemiarthroplasty versus total hip arthroplasty in the elderly: a review of the National Surgical Quality Improvement Program database

详细信息    查看全文

• 作者：Michael A. Fisher ; BS^a ; Jarrod D. Matthei ; BS^a ; Augustine Obirieze ; MD ; MPH^b ; Gezzer Ortega ; MD ; MPH^b ; Daniel D. Tran ; MD^c ; Daniel A. Carnegie ; MD^d ; Patricia L. Turner ; MD^d ; Terrence M. Fullum ; MD^c ; ^{tfullum@howard.edu} ; Marc E. Rankin ; MD^e
• 关键词：Total hip arthroplasty ; Hip fractures ; Open reduction internal fixation ; Hemiarthoplasty ; Femoral neck fractures
• 刊名：Journal of Surgical Research
• 出版年：2013
• 出版时间：15 May, 2013
• 年：2013
• 卷：181
• 期：2
• 页码：193-198
• 全文大小：181 K

文摘

Background

Total hip arthroplasty (THA), hemiarthroplasty (HA), and open reduction internal fixation (ORIF) are treatment options for femoral neck fractures. However, the optimal surgical treatment remains unclear. The present study aimed to describe the 30-d postoperative outcomes of THA, HA, and ORIF among patients aged ¡Ý65 y with femoral neck fractures within a national surgical database.

Materials and methods

A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program for January 2005 through December 2009 was conducted. We included patients aged ¡Ý65 y who had undergone THA, HA, or ORIF for femoral neck fractures. We collected information on patient demographics, comorbidities, risk factors, and complication rates. A logistic regression model was used to assess the variation in overall morbidity and mortality after surgery.

Results

Overall, 3423 patients met the inclusion criteria: 674 underwent ORIF, 428 HA, and 2321 THA. Most patients were white (83.6 % , n = 2862), female (64.4 % , n = 2204), and >70 y old (78.4 % , n?=?2682). On adjusted multivariate analysis, no differences were found in the 30-d mortality rates among the ORIF, HA, and THA groups. Patients who underwent ORIF (odds ratio 0.51, 95 % confidence interval 0.27-0.94) and HA (odds ratio 0.43, 95 % confidence interval 0.22-0.84) had a lower likelihood of developing respiratory complications compared with those who underwent THA.

Conclusions

No differences were found in the 30-d mortality rates among the ORIF, HA, and THA groups. ORIF and HA resulted in a lower likelihood of developing respiratory complications than THA.