gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Morbidity and Mortality after treatment of femoral neck fractures with an uncemented hemiarthroplasty in patients with a biological age of 80 years or more

Meeting Abstract

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  • R. Geerts - Orbis Medical Center, Orthopaedics, sittard-geleen, Netherlands
  • P. Eggen - Elkerliek Hospital, Orthopaedic surgery and traumatology, Helmond, Netherlands

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN20-1720

DOI: 10.3205/10dkou125, URN: urn:nbn:de:0183-10dkou1251

Veröffentlicht: 21. Oktober 2010

© 2010 Geerts et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Several studies have been performed to identify significant predictive values in morbidity and mortality after femoral neck surgery with a cemented hemiarthroplasty. We analysed important significant predictors of post-operative morbidity and mortality in two different uncemented hemiarthroplasties.

Methods: A retrospective study of 113 patients (82 female, 31 male) who have been treated with 114 cementless hemiarthroplasties (71 Omnifit and 43 Symax) for femoral neck fractures between January 2002 and December 2005 was conducted. Median age was 81 years (81.81±6.60). Patient’s medical records were studied for comorbidities and per- and post-operative complications, mortality, and radiographs were analysed.

Results and conclusions: General post-operative mortality at one, six and twelve months follow-up was 8.8%, 23.7% and 34.9% respectively. Mostly seen complications were delirium (23.9%), urinary tract infections (23.0%), cardiac complications (7%), pulmonary complications (7%, no pulmonary embolism), dislocations (n=3, 2.6%, all Omnifit and posterolateral approach), per-operative fractures (n=3, 2.6%, all Omnifit), deep wound infections (n=2, 1.8%), strokes (1.8%) and deep venous thrombosis (n=1, 0.9%). 0 Per-operative deaths, 0 lungembolisms and 1 DVT were seen.

Significant predictive values: Pulmonary co-morbidity was predictive of death within one month (33.3%vs5.7%; p<0.001; OR8.300; 95%CI 2.405–28.650). No significant predictive values were seen for 6 and 12 months post-operative.

Dementia was predictive of delirium (both diagnosed by a geriatric specialist) (40.0%vs19.5%; p<0.05; OR2.745; 95%CI 1.051–7.167).

Calendar age above 80yrs was predictive of urinary tract infection (32.3%vs10.4%; p<0.01; OR4.105; 95%CI 1.419–11.871).

The significant predictors of post-operative morbidity and mortality are consistent with those found in studies about cemented hemiarthroplasties of the hip with a higher risk of the negative effects of cementing. The negative effects of cementing like DVT (literature: 1,3–1,8%) and pulmonary embolism (literature: 0,5–3,0%) and per-operative death (literature: 0,08–0,20%) however can successfully be reduced.