Abstract
Introduction
Periprosthetic fractures of the femur are potentially catastrophic injuries associated with significant morbidity and mortality. Surgical treatment comprises revision arthroplasty or internal fixation. It is well established that a delay in treating patients with hip fracture leads to higher mortality rates, however there is limited evidence regarding mortality rates and the time to surgery in patients with lower limb periprosthetic fractures.
Aim
This study was done to assess if delay to surgery affected the mortality rates in patients with periprosthetic fractures of hip and knee.
Method
We performed a retrospective study on periprosthetic fractures treated at a single centre over the period from 2008 to 2013. Data was obtained based on case notes and operating theatre records and patients were grouped based on time to surgery. Group one included those who underwent surgery within forty eight hours of injury and group two those who had surgery after forty eight hours. We then calculated the overall, as well as individual group mortality rates at one year. Subgroup statistical analysis was then calculated to compare between groups.
Results
Eighty three patients were included for the final review. The overall mortality rate at one year was twenty two percent. The mortality rate for patients who were operated within forty eight hours was twenty nine percent whereas the mortality rate in the group operated after forty eight hours was nineteen percent.
Conclusion
A delay in surgical treatment of lower limb periprosthetic fracture is associated with a reduction in mortality. This occurs in contradistinction to the situation with simple hip fracture. One might speculate that in the former case, appropriate pre-operative optimisation is critically important to prepare patients for their arduous treatment.
