Operative management of femoral neck Fx has changed

(HealthDay)—Trends in operative management of femoral neck fractures by orthopedic surgeons applying for board certification have changed over time, according to research published in the Sept. 3 issue of The Journal of Bone & Joint Surgery.

Benjamin J. Miller, M.D., from the University of Iowa in Iowa City, and colleagues used data obtained from the American Board of Orthopaedic Surgery to examine the utilization of internal fixation, hemiarthroplasty, and total hip arthroplasty among candidates taking Part II of the licensing examination from 1999 to 2011. Data were included for 19,541 femoral neck fractures that had been treated by 4,450 candidates for board certification.

The researchers found that the use of hip arthroplasty increased over time (0.7 percent in 1999 versus 7.7 percent in 2011; P < 0.001), while there were slight declines in the use of hemiarthroplasty (67.1 to 63.1 percent; P = 0.020) and internal fixation (32.2 to 29.2 percent; P = 0.064). An increase in utilization of total hip arthroplasty was seen in all geographic regions, with considerable between-location variation. There was an increase in the percentage of patients younger than 65 years who were managed with total hip arthroplasty (1.4 to 13.1 percent; P < 0.001).

"The most substantial changes in treatment of femoral neck fractures were seen in the younger group of patients," the authors write.

One or more authors disclosed financial ties to an entity in the biomedical arena; one or more authors own a patent or patents related to this work.

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