Trends in surgical treatment of femoral neck fractures in the elderly

• Main Authors: Eva Jolanda Irene Lehtonen, Robert Davis Stibolt Jr, Walter Smith, Bradley Wills, Martim Correia Pinto, Gerald McGwin Jr, Ashish Shah, Alexandre Leme Godoy-Santos, Sameer Naranje
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein
• Series: Einstein (São Paulo)
• Subjects: Idoso; Fraturas do quadril/cirurgia; Fraturas do colo femoral/cirurgia; Procedimentos cirúrgicos operatórios/tendências
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082018000300207&lng=en&tlng=en

ABSTRACT Objective To analyze recent demographic and medical billing trends in treatment of femoral neck fracture of American elderly patients. Methods The American College of Surgeons National Surgical Quality Improvement Program database was analyzed from 2006 to 2015, for patients aged 65 years and older, using the Current Procedural Terminology codes 27130, 27125, 27235, and 27236. Patient demographics, postoperative complications, and frequency of codes were compared and analyzed over time. Our sample had 17,122 elderly patients, in that, 70% were female, mean age of 80.1 years (standard deviation±6.6 years). Results The number of cases increased, but age, gender, body mass index, rates of diabetes and smoking did not change over time. Open reduction internal fixation was the most commonly billed code, with 9,169 patients (53.6%), followed by hemiarthroplasty with 5,861 (34.2%) patients. Combined estimated probability of morbidity was 9.8% (standard deviation±5.2%), and did not change significantly over time. Postoperative complication rates were similar between treatments. Conclusion Demographics and morbidity rates in femoral neck fractures of elderly patients did not change significantly from 2006 to 2015. Open reduction internal fixation was the most common treatment followed by hemiarthroplasty.