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Hip fractures in the elderly are associated with high 1-year mortality rates, but whether patients with other lower extremity fractures are exposed to a similar mortality risk is not clear. QUESTIONS/
We evaluated the mortality of elderly patients after distal femur fractures; determined predictors for mortality; analyzed the effect of surgical delay; and compared survivorship of elderly patients with distal femur fractures with subjects in a matched hip fracture group. PATIENTS AND
We included 92 consecutive patients older than 60 years with low-energy supracondylar femur fractures treated between 1999 and 2009. Patient, fracture, and treatment characteristics were extracted from operative records, charts, and radiographs. Data regarding mortality were obtained from the Social Security Death Index.
Age-adjusted Charlson Comorbidity Index and a previous TKA were independent predictors for decreased survival. Congestive heart failure, dementia, renal disease, and history of malignant tumor led to shorter survival times. Patients who underwent surgery more than 4 days versus 48 hours after admission had greater 6-month and 1-year mortality risks. No differences in mortality were found comparing patients with native distal femur fractures with patients in a hip fracture control group.
Periprosthetic fractures and fractures in patients with dementia, heart failure, advanced renal disease, and metastasis lead to reduced survival. The age-adjusted Charlson Comorbidity Index may serve as a useful tool to predict survival after distal femur fractures. Surgical delay greater than 4 days increases the 6-month and 1-year mortality risks. Mortality after native fractures of the distal femur in the geriatric population is high and similar to mortality after hip fractures. LEVEL OF
Level II, prognostic study. See the guidelines online for a complete description of evidence.
Orthopedic Trauma Service, Department of Orthopedics, Washington University School of Medicine/Barnes-Jewish Hospital, 660 South Euclid Avenue, Campus Box 8233, St Louis, MO, 63110, USA, firstname.lastname@example.org.
This article was published in the following journal.
Name: Clinical orthopaedics and related research
Fractures of the distal femur are rare injuries that are mainly treated operatively. Complication rates remain high.
In this issue of JBMR, Kharazmi et al(1) report a lower risk of mortality in patients who suffer atypical femur fractures (AFF) compared with patients with other, more conventional fractures of the su...
Bilateral femur fractures have been associated with frequent morbidity and mortality. Associated injuries and massive hemorrhage contributed to mortality rates that were as high as 27% in previous rep...
Fractures of the distal femur (the part of the thigh bone nearest the knee) are a considerable cause of morbidity. Various different surgical and non-surgical treatments have been used in the manageme...
Supracondylar intercondylar distal femur fractures are devastating injuries that frequently have a concurrent coronal plane fracture, which mandates dedicated operative fixation. The purpose of this s...
The investigators will be looking at geriatric distal femur fractures. The investigators will prospectively enroll these patients and allow patients to either weight bear as tolerated or l...
Neck of femur fractures are common in the elderly and are the source of significant morbidity and mortality. This study is based on a new technique developed in Ben Gurion University, with...
This study looks at two (2) types of surgical treatments and hopes to answer the question, "which is the best way to surgically treat a distal femur fracture?" Both procedures being studie...
The purpose of this study is to determine whether the rate of fracture healing and fracture union, repaired with the LISS device, will be as good as or better than the usual fracture fixat...
Femur fractures are a common injury in the Pediatric population. Despite their high incidence little do we know about the long term implications on the bones' length. Our main goal is to ...
Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).
Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES.
Fractures of the femur.
Demographic and epidemiologic changes that have occurred in the last five decades in many developing countries and that are characterized by major growth in the number and proportion of middle-aged and elderly persons and in the frequency of the diseases that occur in these age groups. The health transition is the result of efforts to improve maternal and child health via primary care and outreach services and such efforts have been responsible for a decrease in the birth rate; reduced maternal mortality; improved preventive services; reduced infant mortality, and the increased life expectancy that defines the transition. (From Ann Intern Med 1992 Mar 15;116(6):499-504)
Aseptic or avascular necrosis of the femoral head. The major types are idiopathic (primary), as a complication of fractures or dislocations, and LEGG-PERTHES DISEASE.
Osteoporosis is a disease in which the bones become extremely porous, are subject to fracture, and heal slowly, occurring especially in women following menopause and often leading to curvature of the spine from vertebral collapse. Follow and track&n...