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Low BMD and high alcohol consumption predict a major re-operation in patients younger than 70 years of age with a displaced femoral neck fracture-A two -year follow up study in 120 patients.
Campenfeldt, Pierre; Al-Ani, Amer; Hedström, Margareta; Ekström, Wilhelmina.
Afiliación
  • Campenfeldt P; Karolinska Institutet, Department of Clinical Science Intervention and Technology, Sweden; Swedish Armed Forces, Defence Inspector for Medicine and Environmental Health, Tegeluddsvägen 100 SE-107 85, Stockholm, Sweden. Electronic address: pierre.campenfeldt@ki.se.
  • Al-Ani A; Karolinska Institutet, Department of Clinical Science Intervention and Technology, Sweden; Orthopedic Clinic, Vällingby-Läkarhuset, Praktikertjänst AB, Sweden.
  • Hedström M; Karolinska Institutet, Department of Clinical Science Intervention and Technology, Sweden; Department of Orthopaedics, Karolinska University Hospital, Sweden.
  • Ekström W; Department of Orthopaedics, Karolinska University Hospital, Sweden; Karolinska Institutet, Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sport Medicine, Sweden.
Injury ; 49(11): 2042-2046, 2018 Nov.
Article en En | MEDLINE | ID: mdl-30243652
BACKGROUND AND PURPOSE: The recommended treatment of displaced femoral neck fractures (FNF) in patients younger than 70 years of age is fracture reduction and internal fixation (IF). The incidence of re-operation due to nonunion (NU) or avascular necrosis (AVN) has been reported to be between 20-30%. Knowledge of possible predisposing factors needs to be elucidated. The primary aim of this study was to identify factors associated with a major re-operation due to NU or AVN in patients <70 years with a displaced FNF treated with IF. PATIENTS AND METHODS: 128 patients, 20-69 years with a FNF treated with IF. Follow up included radiographic and clinical examination at 4, 12 and 24 months. Logistic regression analysis was used to identify factors associated with re-operation due to NU or AVN. RESULTS: The re-operation rate due to NU or AVN was 6%, 16% and 28% at 4, 12 and 24 months respectively. Patients with low BMD was more likely to be re-operated than those with normal BMD, OR 5.5, CI (95%) 1.15-26.8, and those with a high alcohol consumption had 3.2 times higher odds to be re-operated due to NU or AVN, CI (95%) 1.16-8.76. INTERPRETATION: In more than two thirds (83/120) of the patients the fracture healed after one operation. Moreover, a low BMD and high alcohol consumption were related to a major re-operation. These results suggest that only age as a sole variable for choosing the type of surgical treatment may not be rational.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Reoperación / Consumo de Bebidas Alcohólicas / Curación de Fractura / Fracturas del Cuello Femoral / Fijación Interna de Fracturas Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Injury Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoporosis / Reoperación / Consumo de Bebidas Alcohólicas / Curación de Fractura / Fracturas del Cuello Femoral / Fijación Interna de Fracturas Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Injury Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos