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Hip fractures following intramedullary nailing fixation for femoral fractures.

Authors :
Yamamoto, Norio
Yamakawa, Yasuaki
Inokuchi, Takashi
Iwamoto, Yuki
Inoue, Tomoo
Noda, Tomoyuki
Kawasaki, Keisuke
Ozaki, Toshifumi
Source :
Injury. Mar2022, Vol. 53 Issue 3, p1190-1195. 6p.
Publication Year :
2022

Abstract

<bold>Introduction: </bold>Proximal peri-implant femoral fractures occur following intramedullary nailing (IMN) fixation for trochanteric, femoral shaft, and distal femoral fractures. However, analyses of secondary hip fractures (SHFs) using large clinical samples are lacking. Therefore, we aimed to report the incidence and clinical outcomes of SHF after nailing fixation (IMN or cephalomedullary nailing [CMN]) for overall femoral fractures. In addition, we focused on IMN for femoral shaft fractures and investigated the risk factors for SHF.<bold>Methods: </bold>This multicenter, retrospective, cohort study included 2,293 patients aged > 60 years who underwent nailing fixation for femoral fractures. The primary outcome was the incidence of SHF. In the assessment of clinical outcomes, we evaluated reoperation and the regaining of walking ability following SHF management. In addition, we conducted multivariable logistic regression analyses to examine the association between risk factors and SHF.<bold>Results: </bold>Seventeen (0.7%) patients had SHFs, including 12 femoral neck fractures and 5 trochanteric fractures. Antegrade IMN was the most common type of nailing fixation. Multivariable analysis demonstrated that the absence of femoral head fixation was significantly associated with the incidence of SHF following IMN for femoral shaft fractures (odds ratio, 17.0; 95% confidence interval, 1.9-2265.7; p=0.006). In the assessment of clinical outcomes, there were two reoperations (16.7%) in the secondary femoral neck fracture group. Patients with secondary trochanteric fractures tended to have a lower probability of regaining walking ability than those with secondary femoral neck fractures (20% vs. 50%).<bold>Conclusions: </bold>In this multicenter study, the incidence of SHF after nail fixation for femoral fractures was 0.7%. The absence of femoral head fixation was significantly associated with SHF, and the clinical outcomes were poor. Therefore, femoral head fixation at the initial IMN fixation for femoral fractures may be a fixation option for surgeons to consider as an SHF prevention measure. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00201383
Volume :
53
Issue :
3
Database :
Academic Search Index
Journal :
Injury
Publication Type :
Academic Journal
Accession number :
155340946
Full Text :
https://doi.org/10.1016/j.injury.2021.10.024