Proximal femoral fractures are a typical pathology in elderly patients after a low-energy trauma. This study analyses preexisting risk factors for proximal femoral fractures as well as for failing to reach the previous functional level, difference in outcome between patients with femoral neck fracture compared to those with pertrochanteric fracture, surgical performance and its significance for the functional outcome, as well as the impact of proximal femoral fractures on patients' one-year independence.
Study Type
OBSERVATIONAL
Enrollment
2,906
surgical treatment for proximal femoral fracture with intramedullary nail type Gamma® Nail or similar in case of pertrochanteric fractures
surgical treatment for proximal femoral fracture with a partial hip arthroplasty in case of femoral neck fractures
Department of Orthopaedics and Trauma Surgery (DOTS).
Basel, Switzerland
Change in Patient clinical outcome
Quantification of Rehospitalizations
Time frame: from date of surgery until 1 year follow up period after surgery
Change in Patient clinical outcome
Change in living situation
Time frame: at 1 year follow up date after surgery
Change in Patient clinical outcome
Quantification of major complications with documentation of affected organ System, intensive care Treatment, Discharge where to (home, home with support, in-patient rehabilitation, nursing home), length of hospital stay
Time frame: during hospitalization (from date of surgery until discharge date after surgery (approx. 1-3 weeks)
Change in Patient clinical outcome
Quantification of Reoperations
Time frame: from date of surgery until 1 year follow up period after surgery
Change in Patient clinical outcome
Quantification of infections
Time frame: from date of surgery until 1 year follow up period after surgery
Change in Patient clinical outcome
Quantification of deaths and date of death
Time frame: from date of surgery until 1 year follow up period after surgery
Change in Patient clinical outcome
Change in use of walking aids
Time frame: at 1 year follow up date after surgery
Change in Patient clinical outcome
Change in pain at rest (yes/no),
Time frame: at 1 year follow up date after surgery
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Change in Patient clinical outcome
Change in pain under stress (yes/no)
Time frame: at 1 year follow up date after surgery
Change in Patient clinical outcome
Change in restrictions in daily living (yes/no),
Time frame: at 1 year follow up date after surgery
Change in Patient clinical outcome
Change in use of analgetics (yes/no)
Time frame: at 1 year follow up date after surgery
Change in Patient clinical outcome
Quantification of intensive care Treatment
Time frame: during hospitalization (from date of surgery until discharge date after surgery (approx. 1-3 weeks)
Change in Patient clinical outcome
Quantification of Discharge where to (home, home with support, in-patient rehabilitation, nursing home)
Time frame: during hospitalization (from date of surgery until discharge date after surgery (approx. 1-3 weeks)
Change in Patient clinical outcome
Quantification of length of hospital stay
Time frame: during hospitalization (from date of surgery until discharge date after surgery (approx. 1-3 weeks)
Change in patient clinical outcome (according Penrod score)
Penrod score reflects the patients' preoperative functional level and living. Patients are classified concerning their prefracture age (1: \<75 years, 2: 75-84 years, 3 ≥85 years, their ability in performing activities of daily life (ADL) as well as their cognitive status (dementia in clusters 2B and 3D Situation)
Time frame: preoperatively and at 1 year follow up date after surgery
Change in radiological outcome: assessment of surgical treatment of pertrochanteric fractures
central positioning and insertion of the neck screw
Time frame: day of surgical intervention (immediately after surgery) and 1year postoperative (if n.a. min 6 months postoperative)
radiological outcome: assessment of surgical treatment of femoral neck fractures
development of periacetabular ossification according to Brooker * A islands of bone within the soft tissues about the hip * B bone spurs originating from the pelvis or proximal end of the femur, leaving at least 1 cm between opposing bone surfaces * C bone spurs originating from the pelvis or proximal end of the femur, reducing the space between opposing bone surfaces to less than 1 cm * D bone ankylosis of the hip
Time frame: 1year postoperative (if n.a. min 6 months postoperative)
Change in subsidence (radiological outcome: assessment of surgical treatment of femoral neck fractures)
differences in the distance between perpendicular lines drawn to the bisecting axis of the medullary canal, at the top of the femoral head and at the tip of the great trochanter in mm
Time frame: 1year postoperative (if n.a. min 6 months postoperative)
radiological outcome: assessment of surgical treatment of femoral neck fractures
cortical atrophy i.e. longitudinal intracortical porosis with a consecutive thinning of the cortex without measurable thickening of the femur (yes-no-n.a.)
Time frame: 1year postoperative (if n.a. min 6 months postoperative)
radiological outcome: assessment of surgical treatment of femoral neck fractures
osteolysis i.e. progressive, newly developed endosteal bone loss with a diameter \> 3 mm, either with scalloping or a bead-shaped lucency at the cement-bone interface
Time frame: 1year postoperative (if n.a. min 6 months postoperative)
radiological outcome: assessment of surgical treatment of femoral neck fractures
debonding i.e. radiolucent line at the prosthesis-cement interface not visible on the first postoperative radiograph (yes-no-n.a.)
Time frame: 1year postoperative (if n.a. min 6 months postoperative)
Change in radiological outcome: assessment of surgical treatment of pertrochanteric fractures
leg-length discrepancy (tangent to inferior pubic rami and tip of greater trochanter, if n.a. insertion of lesser trochanter)
Time frame: day of surgical intervention (immediately after surgery) and 1year postoperative (if n.a. min 6 months postoperative)
Change in radiological outcome: assessment of surgical treatment of femoral neck fractures
leg-length discrepancy in mm (tangent to inferior pubic rami and tip of greater trochanter, if n.a. insertion of lesser trochanter)
Time frame: day of surgical intervention (immediately after surgery) and 1year postoperative (if n.a. min 6 months postoperative)
Change in radiological outcome: assessment of surgical treatment of femoral neck fractures
alignment on ap view (central axis of the distal stem to bisecting axis of medullary canal at the isthmus) in °
Time frame: day of surgical intervention (immediately after surgery) and 1year postoperative (if n.a. min 6 months postoperative)