Increased rate of reoperation in atypical femoral fractures is related to patient characteristics and not fracture type. A nationwide cohort study.
Atypical femoral fracture
Bisphosphonates
Complications
Osteoporosis
Reoperation risk
Journal
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
ISSN: 1433-2965
Titre abrégé: Osteoporos Int
Pays: England
ID NLM: 9100105
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
07
06
2019
accepted:
25
11
2019
pubmed:
15
1
2020
medline:
19
3
2021
entrez:
15
1
2020
Statut:
ppublish
Résumé
Atypical femoral fractures are burdened with a high rate of reoperation. In our nationwide analysis, the increased rate of reoperation was related to patient background characteristics, such as age and health status, rather than fracture type. Patients with atypical fractures are complex to treat and burdened with a high risk of reoperation. We hypothesized that patients with surgically treated, complete atypical fractures have a higher risk of any reoperation and reoperation related to healing complications than patients with common femoral shaft fractures but that this increase would become insignificant when adjusted for predefined characteristics. A cohort of 163 patients with atypical fractures and 862 patients with common femoral shaft or subtrochanteric fractures treated from 2008 to 2010 and who had follow-up radiographs and register data available until 31 December 2014 was included. Reoperations were identified by a complementary review of radiographs and register data and were used to calculate risks for any reoperation and reoperations related to healing complications. Patients with atypical fractures were more likely to be reoperated for any reason, age-adjusted OR 1.76 (95% CI, 1.08 to 2.86). However, patients with common fractures had a shorter follow-up due to a threefold higher death rate. Accordingly, in a multivariable-adjusted time-to-event model, the increased risk lost statistical significance for any reoperations, cause-specific HR 1.34 (95% CI, 0.85 to 2.13), and for reoperations related to healing complications, HR 1.32 (95% CI, 0.58 to 3.0). Continued use of bisphosphonate in the first year after the fracture did not affect the reoperation rate. Our findings suggest that the increased risk of reoperation after an atypical femur fracture is largely explained by patient characteristics and not fracture type.
Identifiants
pubmed: 31932963
doi: 10.1007/s00198-019-05249-3
pii: 10.1007/s00198-019-05249-3
pmc: PMC7170820
doi:
Substances chimiques
Diphosphonates
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
951-959Subventions
Organisme : ALF Grant, Östergötland County Council (SE)
ID : LIO-698411
Organisme : Region Gävleborg
ID : CFUG-651191
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