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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 28 - 28
1 Sep 2012
Vinje T Gjertsen J Lie S Engesaeter L Havelin L Furnes O Matre K Fevang J
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Background

Systematic reviews disagree, but some recent studies have shown better function and less pain after operation with bipolar hemiarthroplasty compared to fixation by two screws in elderly patients operated for displaced femoral neck fractures. There is still uncertainty regarding the mortality associated with both procedures.

Aim of the study

To investigate mortality and the risk factors for death among patients with displaced femoral neck fractures within the first three years after surgery, comparing operation with bipolar hemiarthroplasty (HA) and internal fixation (IF) by two screws.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 30 - 30
1 Sep 2012
Vinje T Fevang J Engesaeter L Lie S Havelin L Matre K Gjertsen J Furnes O
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Background

A well conducted randomised study found similar functional results for patients with displaced femoral neck fracture comparing operation with a modern uncemented bipolar hemiarthroplasty with a cemented bipolar hemiarthroplasty. The mortality associated with the two procedures has not been sufficiently investigated.

Aim of study

To investigate the mortality and the risk factors for death among patients with displaced femoral neck fractures the first year after surgery, comparing operation with modern uncemented and cemented bipolar hemiarthroplasty (HA).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 31 - 31
1 Sep 2012
Gjertsen J Vinje T Fevang J Lie SA Furnes O Havelin LI Engesaeter LB
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Introduction

Displaced femoral neck fractures in elderly are normally treated with 2 screws/pins (IF) or bipolar hemiarthroplasty (HA). The aim of this study was to compare IF and HA as treatment for displaced femoral neck fractures using reoperations and functional result (patient satisfaction, pain, and quality of life) as outcome.

Material and Methods

From January 2005 all hip fractures in Norway are reported to the Norwegian Hip Fracture Register. At 4, 12, and 36 months postoperatively a questionnaire assessing satisfaction (VAS 0-100), pain (VAS 0-100), and quality of life (EQ-5D) is sent to the patients. To ensure more than 3 years follow-up, only patients operated in 2005 were included in the present study. Consequently 1,968 patients over 70 years of age operated with IF (n = 958) or HA (n = 1,010) due to displaced femoral neck fractures were included in the analyses on reoperations. Of these, 280 patients responded to all questionnaires and were included in the analyses on functional results (IF: n = 135, HA: n = 145). The patients remained in the same treatment group according to the intention-to-treat principle.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 26 - 26
1 Sep 2012
Gjertsen J Fevang J Vinje T Matre K Engesaeter LB
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Introduction

Undisplaced femoral neck fractures have been given little attention in the literature. By using data from the Norwegian Hip Fracture Register, this study investigates risk for reoperation and the clinical results, including pain, patient satisfaction, and quality of life, after undisplaced femoral neck fractures in elderly patients.

Material and Methods

Data on 4,468 patients over 70 years of age with undisplaced femoral neck fractures operated with internal fixation (IF) were compared to 10,289 patients with displaced femoral neck fractures treated with IF (n = 3,389) or bipolar hemiarthroplasty (n = 6,900). The evaluation was based on number of reported reoperations and patients' assessment (visual analogue scales concerning pain (0–100) and patient satisfaction (0–100), and quality of life (EQ-5D)) four and twelve months postoperatively. The patients were followed for 0–1 year. The Cox multiple regression model was used to construct adjusted survival curves. Subanalyses were performed on undisplaced femoral neck fractures to investigate different risk factors for reoperation.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 230 - 230
1 Sep 2012
Matre K Vinje T Havelin LI Gjertsen J Furnes O Espehaug B Fevang J
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Introduction

The treatment of trochanteric and subtrochanteric fractures remains controversial, and new implants are constantly being developed trying to improve outcome and minimize the number of complications in these fractures.

In Norway the Sliding Hip Screw(SHS), with or without a Trochanteric Stabilizing Plate (TSP), is still the most commonly used implant, but worldwide nailing of these fractures is increasing. This trend, however, has not been supported by documentation of better clinical results compared to the SHS in well designed studies. Therefore, in the present study we compared the recently launched Trigen Intertan nail (Smith and Nephew) with the SHS in the treatment of trochanteric and subtrochanteric fractures.

Patients and Methods

In a prospective, randomized multicenter study with 697 patients, we compared the Trigen Intertan nail with the SHS regarding postoperative pain, functional mobility, complications, and reoperation rates.

Patients older than 60 years with trochanteric and subtrochanteric fractures were included in 5 hospitals. At day 5, and 3 and 12 months postoperatively, pain was measured using a Visual Analogue Scale (VAS), and the Timed Up and Go-test (TUG-test) was performed to evaluate functional mobility. Complications and reoperations were recorded at discharge, and after 3 and 12 months.