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Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Solid organ transplantation (SOT) recipients have complex medical and surgical risk factors; however, the outcomes of these patients undergoing surgical fixation of hip fractures are unknown. This study sought to evaluate SOT patients’ outcomes and survivorship after intertrochanteric (IT) fracture fixation.

Methods

A retrospective review identified 12 SOT patients who underwent cephalomedullary (CMN) nail fixation for IT fractures and were matched (1:2) to a cohort of 24 non-SOT IT fracture patients. Perioperative results and complications, mortality/patient survivorship, and clinical outcomes were compared between the cohorts.

Results

The time from presentation to surgical fixation was within 48 h of presentation for the non-SOT patients, while only 75% of SOT patients underwent surgery within 48 h of presentation (p = 0.034). The 90-day readmission rate for SOT patients was 25% versus 13% in the non-SOT group (p = 0.38). Similarly, the SOT cohort experienced a higher rate of major medical complication (25% vs. 13%, p = 0.38). There were two (16%) reoperations in the SOT group and three (13%) in the non-SOT matched group (p = 0.99). Respectively, the 90-day and 1-year estimated patient survivorship was similar between the two cohorts: SOT patients with 92% (95% CI 54–99%) and 73% (95% CI 24–93%) versus 86% (95% CI 62–95%) and 72% (95% CI 47–86%, HR 0.92, 95% CI 0.18–4.62, p = 0.92) in non-SOT patients.

Conclusion

SOT patients who underwent CMN fixation for IT fractures required more time from hospital presentation to surgical management than non-SOT patients. Although not statistically significant, SOT patients demonstrated more acute complications and readmissions, but similar mortality compared to those without transplant.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Michael J. VanWagner, Steven B. Porter, Aaron C. Spaulding, Glenn G. Shi, Benjamin K. Wilke & Cameron K. Ledford

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  1. Michael J. VanWagner
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  2. Steven B. Porter
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  3. Aaron C. Spaulding
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  4. Glenn G. Shi
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  6. Cameron K. Ledford
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Correspondence to Cameron K. Ledford.

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The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of Mayo Clinic who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of Mayo Clinic.

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This is a retrospective study. No informed consent was obtained and no specific patient identifying details or images are presented.

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Investigation performed at the Mayo Clinic, Jacksonville, FL

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VanWagner, M.J., Porter, S.B., Spaulding, A.C. et al. Intertrochanteric fracture fixation in solid organ transplant patients: outcomes and survivorship. Arch Orthop Trauma Surg 142, 2739–2745 (2022). https://doi.org/10.1007/s00402-021-04096-4

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