Risk assessment of hemiarthroplasty and internal fixation of proximal femoral nail antirotation for treating hip fractures in older adults

doi:10.3969/j.issn.2095-4344.1329

Abstract

Abstract:

BACKGROUND: Methods of hip fracture repair include arthroplasty and proximal femoral nail antirotation placement. Whether Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity is feasible for risk assessment before bone surgeries needs to be investigated.

OBJECTIVE: To compare the preoperative prediction and actual mortality in senile hip fracture treated with different implants based on Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity, so as to explore the clinical application value of the scoring system.

METHODS: One hundred and sixty-six cases of hip fractures with the age of above 70 years admitted in the Zhengzhou Orthopaedics Hospital from January 2016 to January 2017 were collected, and assigned into hemiarthroplasty group (bipolar artificial femoral head replacement, n=85, femoral neck fracture), and proximal femoral nail antirotation group (n=81, intertrochanteric fracture). All patients signed the informed consents, and the study was approved by the ethics committee of the hospital. The total mortality rate of 166 patients was calculated, and then the actual mortality rate in the two groups was calculated. The predictive mortality rate of all patients and two groups was calculated by Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity system. The actual and predictive data were compared and analyzed.

RESULTS AND CONCLUSION: (1) The actual mortality rate of 166 patients (including 12 cases of death) was 7.2%, and the predictive mortality rate was 5.4%. (2) The actual mortality rate in the hemiarthroplasty group (totally 85 cases, 4 cases of death) was 4.7%, and the predictive mortality rate was 3.5%. (3) The actual mortality rate in the proximal femoral nail antirotation group (totally 81 cases, 8 cases of death) was 9.9%, and the predictive mortality rate was 6.2%. (4) There was no significant difference in the actual mortality rate and predictive mortality rate (P > 0.05). (5) In summary, Portsmouth-Physiological and Operative Severity Score system for the Enumeration of Mortality and Morbidity system can objectively and effectively predict the risk of the older adults with hip fractures undergoing hemiarthroplasty and internal fixation of proximal femoral nail antirotation.

Key words: Portsmouth-Physiological and Operative Severity Score system, femoral neck fracture, intertrochanteric fracture, bipolar artificial femoral head replacement, proximal femoral nail antirotation, actual case mortality rate, predictive mortality rate

CLC Number:

R459.9|R683.3|R318

Zuo Sili. Risk assessment of hemiarthroplasty and internal fixation of proximal femoral nail antirotation for treating hip fractures in older adults[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(28): 4440-4445.

Figures/Tables 5

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