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Mukka, Sebastian
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Publications (10 of 43) Show all publications
Wolf, O., Sjöholm, P., Hailer, N. P., Möller, M. & Mukka, S. (2020). Study protocol: HipSTHeR - a register-based randomised controlled trial - hip screws or (total) hip replacement for undisplaced femoral neck fractures in older patients. BMC Geriatrics, 20(1), Article ID 19.
Open this publication in new window or tab >>Study protocol: HipSTHeR - a register-based randomised controlled trial - hip screws or (total) hip replacement for undisplaced femoral neck fractures in older patients
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2020 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, no 1, article id 19Article in journal (Refereed) Published
Abstract [en]

Background: Femoral neck fractures (FNFs), which are common in the older population, are associated with high mortality and morbidity. Some 20% of FNFs are undisplaced (uFNFs). The routine surgical procedure for uFNFs is internal fixation (IF) with 2-3 screws/pins with a reported reoperation rate in older patients (age >= 75 years) of up to 21%. The reoperation rate for hemiarthroplasties for displaced fractures is lower than for undisplaced fractures operated with IF. This study will aim to determine whether the outcome for older patients with an uFNF can be improved by replacing the hip instead of preserving it.

Methods: A national multicentre, register-based, randomised controlled trial (rRCT) will be conducted. For this trial, 1440 patients, >= 75 years with an acute uFNF, will be allocated. Eligible patients will be identified by the Swedish Fracture Register (SFR) platform, which will notify the admitting orthopaedic surgeon of eligibility. After informed consent has been given and documented, patients will be randomised to either IF (control group) or arthroplasty (intervention group) within the SFR platform. Injury mechanism, fracture classification, date of injury, and type of treatment are registered in the SFR. Type and brand of arthroplasty, surgical approach, and fixation are obtained from the Swedish Hip Arthroplasty Register (SHAR). The study cohort from the SFR will be cross-checked with the National Patient Register and the SHAR for outcome variables at 2, 5, and 10 years.

The primary outcome will be a composite variable comprising reoperation rate and mortality at 2 years postoperatively. Secondary endpoints will include reoperation rate and mortality as stand-alone variables. In addition, secondary endpoints will be patient-reported outcomes as measured by the Short Musculoskeletal Functional Assessment questionnaire at 1 year postoperatively as routinely collected within the SFR. Further secondary endpoints will include the occurrence of adverse events such as pneumonia, stroke or myocardial infarction and evaluation of the external validity of the study.

Discussion: This large, multicentre, register-based randomised controlled trial could potentially shift the treatment of uFNFs in older patients towards primary hip arthroplasty in order to improve the outcome.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Hip fracture, Femoral neck fracture, Internal fixation, Hip arthroplasty, Register, Register-based randomised controlled trial
National Category
Orthopaedics Geriatrics
Identifiers
urn:nbn:se:umu:diva-169759 (URN)10.1186/s12877-020-1418-2 (DOI)000521304800001 ()31964340 (PubMedID)
Available from: 2020-05-13 Created: 2020-05-13 Last updated: 2020-05-13Bibliographically approved
Mellner, C., Hedström, M., Hommel, A., Sköldenberg, O., Eisler, T. & Mukka, S. (2020). The Sernbo score as a predictor of 1-year mortality after hip fracture: a registry study on 55,716 patients.. European Journal of Trauma and Emergency Surgery
Open this publication in new window or tab >>The Sernbo score as a predictor of 1-year mortality after hip fracture: a registry study on 55,716 patients.
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2020 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: Patients sustaining a hip fracture have a high mortality rate during the first postoperative year and the Sernbo score may stratify patients into a high, intermediate and low risk of death during this period. We assessed its predictive properties on patients from the National Swedish Hip Fracture Register.

PATIENTS AND METHODS: 55,716 hip fracture patients, 69% women older than 65 years at surgery (registered between 2010 and 2015) with complete Sernbo scores and mortality data were studied. Receiver-operating characteristics analyses (ROC) were used. Validation of Sernbo score was performed.

RESULTS: The overall 1-year mortality rate was 26%-and 17%, 27.4% and 55.6% in the low, intermediate and high-risk groups, respectively. The ROC analysis indicated a predictive ability of the Sernbo score, with an AUC of 0.69 (CI 0.68-0.69).

CONCLUSION: In this registry-based study, the easy-to-use Sernbo scoring system proved to be appropriate and useful way to identify hip fracture patients with a high-risk mortality during the first postoperative year.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Elderly, Femoral neck fracture, Hip fracture, Mortality, Score
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-170581 (URN)10.1007/s00068-020-01375-4 (DOI)32363412 (PubMedID)
Available from: 2020-05-11 Created: 2020-05-11 Last updated: 2020-05-11
Sköldenberg, O. G., Rysinska, A. D., Chammout, G., Salemyr, M., Mukka, S., Bodén, H. & Eisler, T. (2019). A randomized double-blind noninferiority trial, evaluating migration of a cemented vitamin E-stabilized highly crosslinked component compared with a standard polyethylene component in reverse hybrid total hip arthroplasty. The Bone & Joint Journal, 101-B(10), 1192-1198
Open this publication in new window or tab >>A randomized double-blind noninferiority trial, evaluating migration of a cemented vitamin E-stabilized highly crosslinked component compared with a standard polyethylene component in reverse hybrid total hip arthroplasty
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2019 (English)In: The Bone & Joint Journal, ISSN 2049-4394, E-ISSN 2049-4408, Vol. 101-B, no 10, p. 1192-1198Article in journal (Refereed) Published
Abstract [en]

AIMS: Radiostereometric analysis (RSA) studies of vitamin E-doped, highly crosslinked polyethylene (VEPE) liners show low head penetration rates in cementless acetabular components. There is, however, currently no data on cemented VEPE acetabular components in total hip arthroplasty (THA). The aim of this study was to evaluate the safety of a new cemented VEPE component, compared with a conventional polyethylene (PE) component regarding migration, head penetration, and clinical results.

PATIENTS AND METHODS: We enrolled 42 patients (21 male, 21 female) with osteoarthritis and a mean age of 67 years (sd 5), in a double-blinded, noninferiority, randomized controlled trial. The subjects were randomized in a 1:1 ratio to receive a reverse hybrid THA with a cemented component of either argon-gas gamma-sterilized PE component (controls) or VEPE, with identical geometry. The primary endpoint was proximal implant migration of the component at two years postoperatively measured with RSA. Secondary endpoints included total migration of the component, penetration of the femoral head into the component, and patient-reported outcome measurements.

RESULTS: In total, 19 control implants and 18 implants in the VEPE group were analyzed for the primary endpoint. We found a continuous proximal migration of the component in the VEPE group that was significantly higher with a difference at two years of a mean 0.21 mm (95% confidence interval (CI) 0.05 to 0.37; p = 0.013). The total migration was also significantly higher in the VEPE group, but femoral head penetration was lower. We found no difference in clinical outcomes between the groups.

CONCLUSION: At two years, this cemented VEPE component, although having a low head penetration and excellent clinical results, failed to meet noninferiority compared with the conventional implant by a proximal migration above the proposed safety threshold of RSA. The early proximal migration pattern of the VEPE component is a reason for continued monitoring, although a specific threshold for proximal migration and risk for later failure cannot be defined and needs further study.

Place, publisher, year, edition, pages
The British Editorial Society of Bone & Joint Surgery, 2019
Keywords
Cemented component, Highly crosslinked polyethylene, Radiostereometry, Randomized clinical trial, Total hip arthroplasty, Vitamin E
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-163878 (URN)10.1302/0301-620X.101B10.BJJ-2019-0456.R2 (DOI)000488617100005 ()31564144 (PubMedID)
Funder
Stockholm County Council
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2019-11-07Bibliographically approved
Sayed-Noor, A., Mukka, S., Mohaddes, M., Kärrholm, J. & Rolfson, O. (2019). Body mass index is associated with risk of reoperation and revision after primary total hip arthroplasty: a study of the Swedish Hip Arthroplasty Register including 83,146 patients. Acta Orthopaedica, 90(3), 220-225
Open this publication in new window or tab >>Body mass index is associated with risk of reoperation and revision after primary total hip arthroplasty: a study of the Swedish Hip Arthroplasty Register including 83,146 patients
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2019 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 90, no 3, p. 220-225Article in journal (Refereed) Published
Abstract [en]

Background and purpose: The prevalence of obesity is on the rise, becoming a worldwide epidemic. The main purpose of this register-based observational study was to investigate whether different BMI classes are associated with increased risk of reoperation within 2 years, risk of revision within 5 years, and the risk of dying within 90 days after primary total hip arthroplasty (THA). We hypothesized that increasing BMI would increase these risks.

Patients and methods: We analyzed a cohort of 83,146 patients who had undergone an elective THA for primary osteoarthritis between 2008 and 2015 from the Swedish Hip Arthroplasty Register (SHAR). BMI was classified according to the World Health Organization (WHO) into 6 classes: < 18.5 as underweight, 18.5-24.9 as normal weight, 25-29.9 as overweight, 30-34.9 as class I obesity, 35-39.9 as class II obesity, and ≥ 40 as class III obesity.

Results: Both unadjusted and adjusted parameter estimates showed increasing risk of reoperation at 2 years and revision at 5 years with each overweight and obesity class, mainly due to increased risk of infection. Uncemented and reversed hybrid fixations and surgical approaches other than the posterior were all associated with increased risk. Obesity class III (≥ 40), male sex, and increasing ASA class were associated with increased 90-day mortality.

Interpretation: Increasing BMI was associated with 2-year reoperation and 5-year revision risks after primary THA where obese patients have a higher risk than overweight or normal weight patients. As infection seems to be the main cause, customizing preoperative optimization and prophylactic measures for obese patients may help reduce risk.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-157811 (URN)10.1080/17453674.2019.1594015 (DOI)000464635000001 ()30931664 (PubMedID)
Available from: 2019-04-03 Created: 2019-04-03 Last updated: 2019-06-13Bibliographically approved
Mukka, S., Sjöholm, P., Chammout, G., Kelly-Pettersson, P., Sayed-Noor, A. & Sköldenberg, O. (2019). External Validity of the HOPE-Trial Hemiarthroplasty Compared with Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Octogenarians. JBJS Open Access, 4(2), 1-7, Article ID e0061.
Open this publication in new window or tab >>External Validity of the HOPE-Trial Hemiarthroplasty Compared with Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Octogenarians
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2019 (English)In: JBJS Open Access, ISSN 2472-7245, Vol. 4, no 2, p. 1-7, article id e0061Article in journal (Refereed) Published
Abstract [en]

Background: Randomized controlled trials (RCTs) are the most reliable way of evaluating the effect of new treatments by comparing them with previously accepted treatment regimens. The results obtained from an RCT are extrapolated from the study environment to the general health care system. The ability to do so is called external validity. We sought to evaluate the external validity of an RCT comparing the results of total hip arthroplasty with those of hemiarthroplasty for the treatment of displaced femoral neck fractures in patients ≥80 years of age.

Methods: This prospective, single-center cohort study included 183 patients ≥80 years of age who had a displaced femoral neck fracture. All patients were screened according to the inclusion and exclusion criteria for an RCT comparing total hip arthroplasty and hemiarthroplasty. The population for this study consisted of patients who gave their informed consent and were randomized into the RCT (consenting group, 120 patients) as well as those who declined to give their consent to participate (non-consenting group, 63 patients). The outcome measurements were mortality, complications, and patient-reported outcome measures. Follow-up was carried out postoperatively with use of a mailed survey that included patient-reported outcome questionnaires.

Results: We found a statistically significant and clinically relevant difference between the groups, with the non-consenting group having a higher risk of death compared with the consenting group. (hazard ratio, 4.6; 95% confidence interval, 1.9 to 11.1). No differences were found between the groups in terms of patient-reported outcome measures or surgical complications.

Conclusions: This cohort study indicates a higher mortality rate but comparable hip function and quality of life among eligible non-consenters as compared with eligible consenters when evaluating the external validity of an RCT in patients ≥80 years of age with femoral neck fracture.

Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Place, publisher, year, edition, pages
JBJS, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-161074 (URN)10.2106/JBJS.OA.18.00061 (DOI)
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-06-28Bibliographically approved
Chammout, G., Kelly-Pettersson, P., Hedbeck, C.-J., Stark, A., Mukka, S. & Sköldenberg, O. (2019). HOPE-Trial: Hemiarthroplasty Compared with Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Octogenarians: A Randomized Controlled Trial. JB & JS open access, 4(2), Article ID e0059.
Open this publication in new window or tab >>HOPE-Trial: Hemiarthroplasty Compared with Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Octogenarians: A Randomized Controlled Trial
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2019 (English)In: JB & JS open access, E-ISSN 2472-7245, Vol. 4, no 2, article id e0059Article in journal (Refereed) Published
Abstract [en]

Background: The choice of primary hemiarthroplasty or total hip arthroplasty in patients ≥80 years of age with a displaced femoral neck fracture has not been adequately studied. As the number of healthy, elderly patients ≥80 years of ageis continually increasing, optimizing treatments for improving outcomes and reducing the need for secondary surgery is an important consideration. The aim of the present study was to compare the results of hemiarthroplasty with those of totalhip arthroplasty in patients ≥80 years of age.

Methods: This prospective, randomized, single-blinded trial included 120 patients with a mean age of 86 years (range, 80 to 94 years) who had sustained an acute displaced femoral neck fracture <36 hours previously. The patients were randomized to treatment with hemiarthroplasty (n = 60) or total hip arthroplasty (n = 60). The primary end points were hip function and health-related quality of life at 2 years. Secondary end points included hip-related complications and reoperations, mortality, pain in the involved hip, activities of daily living, surgical time, blood loss, and general complications.The patients were reviewed at 3 months and 1 and 2 years.

Results: We found no differences between the groups in terms of hip function, health-related quality of life, hip-related complications and reoperations, activities of daily living, or pain in the involved hip. Hip function, activities of daily living,and pain in the involved hip deteriorated in both groups compared with pre-fracture values. The ability to regain previous walking function was similar in both groups.

Conclusions: We found no difference in outcomes after treatment with either hemiarthroplasty or total hip arthroplasty inactive octogenarians and nonagenarians with a displaced femoral neck fracture up to 2 years after surgery. Hemiarthroplastyis a suitable procedure in the short term for this group of patients.

Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Place, publisher, year, edition, pages
The Journal of Bone and Joint Surgery, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-158836 (URN)10.2106/JBJS.OA.18.00059 (DOI)31334466 (PubMedID)
Available from: 2019-05-10 Created: 2019-05-10 Last updated: 2020-01-07Bibliographically approved
Mellner, C., Mohammed, J., Larsson, M., Esberg, S., Szymanski, M., Hellström, N., . . . Mukka, S. (2019). Increased risk for postoperative periprosthetic fracture in hip fracture patients with the Exeter stem than the anatomic SP2 Lubinus stem.. European Journal of Trauma and Emergency Surgery
Open this publication in new window or tab >>Increased risk for postoperative periprosthetic fracture in hip fracture patients with the Exeter stem than the anatomic SP2 Lubinus stem.
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2019 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: The purpose of this study was to compare the cumulative incidence of postoperative periprosthetic fracture (PPF) in a cohort of femoral neck fracture (FNF) patients treated with two commonly used cemented stems: either a collarless, polished, tapered Exeter stem or the anatomic Lubinus SP2 stem.

METHODS: In this retrospective multicenter cohort study of a consecutive series of patients, we included 2528 patients of age 60 years and above with an FNF who were treated with either hemiarthroplasty or total hip arthroplasty using either a polished tapered Exeter stem or an anatomic Lubinus SP2 stem. The incidence of PPF was assessed at a minimum of 2 years postoperatively.

RESULTS: The incidence of PPF was assessed at a median follow-up of 47 months postoperatively. Thirty nine patients (1.5%) sustained a PPF at a median of 27 months (range 0-96 months) postoperatively. Two of the operatively treated fractures were Vancouver A (5%), 7 were Vancouver B1 (18%), 10 were Vancouver B2 (26%), 7 were Vancouver B3 (18%), and 13 were Vancouver C (32%). The cumulative incidence of PPF was 2.3% in the Exeter group compared with 0.7% in the SP2 group (p < 0.001). The HR was 5.4 (95% CI 2.4-12.5, p < 0.001), using the SP2 group as the denominator.

CONCLUSIONS: The Exeter stem was associated with a higher risk for PPF than the Lubinus SP2 stem. We suggest that the tapered Exeter stem should be used with caution in the treatment of FNF.

TRIAL REGISTRATION: The study was registered at clinicaltrials.gov (identifier: NCT03326271).

Keywords
Femoral neck fracture, Hip arthroplasty, Hip fracture, Mortality, Periprosthetic fracture
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-165384 (URN)10.1007/s00068-019-01263-6 (DOI)31740996 (PubMedID)
Note

Originally included in thesis in manuscript form

Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-11-26
Sjöholm, P., Otten, V. T., Wolf, O., Gordon, M., Karsten, G., Sköldenberg, O. & Mukka, S. (2019). Posterior and anterior tilt increases the risk of failure after internal fixation of Garden I and II femoral neck fracture. Acta Orthopaedica, 90(6), 537-541
Open this publication in new window or tab >>Posterior and anterior tilt increases the risk of failure after internal fixation of Garden I and II femoral neck fracture
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2019 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 90, no 6, p. 537-541Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Preoperative posterior tilt of the femoral head as seen on lateral radiographs has been reported to affect the risk of fixation failure in cases of minimally displaced femoral neck fractures (Garden I-II). We investigated radiological risk factors of treatment failure.

Patients and methods - We included 417 patients (68% women, median age: 78 years (50-108) with a minimally displaced femoral neck fracture (Garden I-II) treated with internal fixation in a retrospective cohort study. The patients were followed for 3.4 years (2-14). Data on age, sex, housing, cognitive impairment, implant angulation, pre- and postoperative tilt, hip complications, and reoperations were recorded. The risk of fixation failure was assessed using Cox proportional hazards regression analysis.

Results - The overall reoperation rate was 17%, and the rate of treatment failure (fixation failure, nonunion, avascular necrosis, or posttraumatic osteoarthritis) was 13%. Cox proportional hazard analysis revealed an increased risk of treatment failure with a preoperative posterior tilt of at least 20° and a preoperative anterior tilt greater than 10°. A failure occurred in 13 of the 65 patients with a posterior tilt of at least 20° and in 5 of the 9 patients with an anterior tilt greater than 10°.

Interpretation - A preoperative posterior tilt of 20° and an anterior tilt greater than 10° in cases of Garden I and II femoral neck fractures increase the risk of fixation failure necessitating additional surgery. In this group of patients, there is a need for future interventional studies regarding the feasibility of primary hip arthroplasty.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-161412 (URN)10.1080/17453674.2019.1637469 (DOI)000474308800001 ()31269853 (PubMedID)2-s2.0-85068592440 (Scopus ID)
Available from: 2019-07-05 Created: 2019-07-05 Last updated: 2020-01-08Bibliographically approved
Mohammed, J., Mukka, S., Hedbeck, C.-J., Chammout, G., Gordon, M. & Sköldenberg, O. (2019). Reduced periprosthetic fracture rate when changing from a tapered polished stem to an anatomical stem for cemented hip arthroplasty: an observational prospective cohort study with a follow-up of 2 years. Acta Orthopaedica, 90(5), 427-432
Open this publication in new window or tab >>Reduced periprosthetic fracture rate when changing from a tapered polished stem to an anatomical stem for cemented hip arthroplasty: an observational prospective cohort study with a follow-up of 2 years
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2019 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 90, no 5, p. 427-432Article in journal (Refereed) Published
Abstract [en]

Background and purpose - Straight collarless polished tapered stems have been linked to an increased risk for periprosthetic femur fractures in comparison with anatomically shaped stems, especially in elderly patients. Therefore, we evaluated the effect of an orthopedic department's full transition from the use of a cemented collarless, polished, tapered stem to a cemented anatomic stem on the cumulative incidence of postoperative periprosthetic fracture (PPF). Patients and methods - This prospective single-center cohort study comprises a consecutive series of 1,077 patients who underwent a cemented hip arthroplasty using either a collarless polished tapered stem (PTS group, n = 543) or an anatomic stem (AS group, n = 534). We assessed the incidence of PPF 2 years postoperatively and used a Cox regression model adjusted for age, sex, ASA class, cognitive impairment, BMI, diagnosis, and surgical approach for outcome analysis. Results - Mean age at primary surgery was 82 years (49-102), 73% of the patients were female, and 75% underwent surgery for a femoral neck fracture. The PPF rate was lowered from 3.3% (n = 18) in the PTS group to 0.4% (n = 2) in the AS group. The overall complication rate was also lowered from 8.8% in the PTS group to 4.5% in the AS group. In the regression model only cognitive dysfunction (HR 3.8, 95% CI 1.4-10) and the type of stem (PTS vs AS, HR 0.1, CI 0.0-0.5) were correlated with outcome. Interpretation - For elderly patients with poor bone quality use of cemented anatomic stems leads to a substantial reduction in periprosthetic fracture rate without increasing other complications.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-159714 (URN)10.1080/17453674.2019.1624339 (DOI)000486111700003 ()31154885 (PubMedID)
Available from: 2019-06-04 Created: 2019-06-04 Last updated: 2019-11-05Bibliographically approved
Farhang, M., Mukka, S., Bergström, U., Svensson, O. & Sayed-Noor, A. S. (2019). The trend of radiological severity of hip fractures over a 30 years period: a cohort study. BMC Musculoskeletal Disorders, 20(1), Article ID 358.
Open this publication in new window or tab >>The trend of radiological severity of hip fractures over a 30 years period: a cohort study
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2019 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 20, no 1, article id 358Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite advances in operative techniques and preoperative care, proximal femur fractures (PFF) still represent a great public health problem. Displacement and fracture stability have been assumed as important determinants of treatment modality and outcome in such fractures. Purpose of this study was to determine whether the radiological severity of PFF fractures has increased over time.

METHODS: In a cohort study, the plain radiographs of all patients with PFF aged over 50 years who were admitted to Umeå University Hospital in 1981/82, 2002 and 2012 were recruited to examine the types of fractures.

RESULTS: The ratio of undisplaced to displaced femoral neck (FN) fractures was 30 to 70% in 1981/82, 28 to 72% in 2002 and 25 to 75% in 2012. The ratio of stable to unstable intertrochanteric (IT) fractures was 64 to 36% in 1981/82, 68 to 32% in 2002 and 75 to 25% in 2012. The ratio of simple to comminute subtrochanteric fractures was 35 to 65% in 1981/82, 16 to 84% in 2002 and 12 to 88% in 2012. In both FN and IT fractures we found no statistical difference among these 3 study periods, p = 0.67 and p = 0.40. In subtrochanteric fractures we saw a tendency towards more comminute subtrochanteric fractures (1981/82 to 2012), p = 0.09.

CONCLUSIONS: We found no significant increment in the radiological severity of FN and IT over a 30 years' period. However, there was tendency towards an increase in comminute subtrochanteric fractures.

Keywords
Hip fracture, Proximal femoral fracture, Severity, Trend
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-162379 (URN)10.1186/s12891-019-2739-1 (DOI)31391031 (PubMedID)
Available from: 2019-08-19 Created: 2019-08-19 Last updated: 2019-10-09Bibliographically approved
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