Abstract
Proximal femoral fractures in adults under 50 years are not as common as in the elderly, but may have just as significant an impact. There is little in the literature describing the functional outcomes of fixation in this age group. Our aim was to assess the clinical and functional outcomes of operative management of extracapsular proximal femoral fractures (AO 31-A) in the young adult (<50 years). Consecutive skeletally mature patients <50 years undergoing operative fixation of these fractures were obtained from a prospective database over a 12-year period. Complications and mortality data were obtained from this database and case note review. Outcome scores were obtained via postal questionnaires. Eighty-eight patients were included in the study of which 74 (84%) had fixation with the dynamic hip screw. The mean age was 39 years (range 17–50) with a male preponderance (73.8%). Mean hospital stay was 14 days (range 2–94). Seventeen (19.3%) patients had died at a mean of 40 months from their operation date. The 1-year mortality was 4.5%. There were five complications (5.7%). SF-36 and EuroQol 5D scores showed that 5–10% had severe problems with a 20% decrease in quality of life compared to population norms. The biggest differences were in the physical function modalities. One-third had fair to poor hip function as assessed by the Oxford Hip Score. Though these injuries are relatively rare in this age group, they do have significant mortality and functional impairment reflecting a higher energy of injury rather than the frailty seen in the elderly.
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Approval for the project was granted by the institutional research and audit department (Nottingham University Hospitals NHS Trust) as part of a clinical audit.
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DN Ramoutar, corresponding author, analysed the data and wrote the manuscript. P Kodumuri collected the data and wrote the manuscript. JN Rodrigues performed statistical analyses and wrote the manuscript. S Olewicz collected the data. CG Moran and BJ Ollivere, senior authors, wrote and edited the manuscript. DP Forward, senior author, analysed the data and wrote and edited the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Ramoutar, D.N., Kodumuri, P., Rodrigues, J.N. et al. The epidemiology and functional outcomes of operative fixation of extracapsular proximal femoral fractures (AO 31-A) in young adults. Eur J Orthop Surg Traumatol 27, 267–272 (2017). https://doi.org/10.1007/s00590-016-1887-3
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DOI: https://doi.org/10.1007/s00590-016-1887-3