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Current concepts for treating proximal femur fractures in Europe

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Introduction

Proximal femur fractures (PFFs) are frequent injuries in the elderly patient population of every trauma centre. This type of facture represents the most important socio-economic impact of osteoporosis. A European standard of care has not been established yet.

Material and methods

The aim of the study is to evaluate the standards in treatment of this fracture within the EFORT (European Federation of National Associations of Orthopaedics and Traumatology). Within the annual congress 2013 and online EFORT home page, 581 surgeons were asked by a questionnaire. The PFF treatment Europe survey focused on training of the surgeons as well as the number of proximal femur fractures treated in their hospitals and by themselves. Furthermore, the survey consisted of five different cases of a PFF. Each fracture had to be classified by the AO (Arbeitsgemeinschaft für Osteosynthese) classification. After that, the decision for operative or non-operative treatment had to be made. The implant for this type of fracture had to be chosen. At the end of each case, a postoperative X-ray with an osteosynthesis according to AO/ASIF (Association for the Study of Internal Fixation) was shown and the surgeons had to decide whether they agree to the treatment.

Results

In a case of AO/ASIF-type B3 fracture, 73.72 % of the surgeons classified it correctly, 82.78 % in a case of AO/ASIF-type B1 fracture, 26.86 % in a case of A1 fracture (due to the missing second plane), 63.70 % in a case of A3 fracture and 95.18 % in a case of A1 fracture, respectively. The treatment was agreed with in the following: 74.14 % in a case of B3, 89.33 % in a case of B1, 63.72 % in a case of B2, 86.73 % in a case of A3 and 93.09 % in a case of A1 fracture.

Conclusion

In conclusion, the current European system of education and training in combination with the increasing cooperation between the countries has improved the overall understanding of PFF fracture patterns. Although there are still regional differences in the treatment of PFF, the major principles in addressing PFF throughout Europe are meanwhile more congruent than those two decades ago. The study proves a successful implementation of the topic “trauma” within the European education course concepts.

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Conflict of interest

The authors are members of the EFORT Trauma Task Force. The authors express their thanks to the EFORT head office for the support in the conduct of the survey.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma, University Clinic Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    A. Scola & F. Gebhard

  2. Charité, Campus Virchow, Berlin, Germany

    N. Haas

  3. BG Trauma Hospital Tübingen, Tübingen, Germany

    U. Stöckle

  4. Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, UK

    P. Giannoudis

  5. Orthopaedic and Trauma Department, Pavilion T, E. Herriot Hospital, CHU Lyon, Lyon, France

    J. C. Bel

  6. Department of Orthopaedics, Odense University Hospital, Odense, Denmark

    M. S. Larsen

  7. Department of Surgery and Orthopaedics, Lugano, Switzerland

    C. Candrian

  8. Centre Hospitalari Andorrà, Escaldes-Engordany, Principality of Andorra

    J. M. Munoz-Vives

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  1. A. Scola
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  2. N. Haas
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  3. U. Stöckle
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  4. P. Giannoudis
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  5. J. C. Bel
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  8. J. M. Munoz-Vives
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  9. F. Gebhard
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Correspondence to A. Scola.

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Scola, A., Haas, N., Stöckle, U. et al. Current concepts for treating proximal femur fractures in Europe. Eur Orthop Traumatol 5, 329–333 (2014). https://doi.org/10.1007/s12570-014-0259-x

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  • DOI: https://doi.org/10.1007/s12570-014-0259-x

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