Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases
Purpose Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and t...
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| Veröffentlicht in: | International orthopaedics 2012-11, Vol.36 (11), p.2219-2223 |
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| creator | Biber, Roland Brem, Matthias Singler, Katrin Moellers, Manfred Sieber, Cornel Bail, Hermann Josef |
| description | Purpose
Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches.
Methods
We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with self-centring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.
Results
After a dorsal approach 10.5 % [confidence interval (CI) 7.7–13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7–13.6 %), which was not significantly different (
p
= 0.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2–5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0–1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5–8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2–2.2 %). The frequency of the other types of complications did not significantly differ.
Conclusions
The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma. |
| doi_str_mv | 10.1007/s00264-012-1624-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3479273</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1115065594</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-f7f8370e14b8d9dd866b25c1eb348c1a487870c64acfdac30c9d936447f195953</originalsourceid><addsrcrecordid>eNp9kcGKFDEQhoMo7uzqA3iRHL20ptLpTrcHQVZdhQUveg6ZdPV0lkzSproH5h186M0w66IXoSBQ9f9_kvoYewXiLQih35EQslWVAFlBK1WlnrANqFpWDfTNU7YRtYJKtn1zwS6J7oQA3XbwnF1I2WmpADbs96eUyQZ-wEwr8SXbSLuwLlh6dp5zsm7iY8p88jOfcO9tXqac5mBpOb7nNpay4UieeBo52hyO3KX9HLyzi0-RuI-c8ICRT2scMg7FMJTENRddJHTr4g_InSWkF-zZaAPhy4fziv388vnH9dfq9vvNt-uPt5VTSi7VqMeu1gJBbbuhH4aubbeycYDbWnUOrOp0p4VrlXXjYF0tXD_0dauUHste-qa-Yh_OufO63ePgMJZ_BzNnv7f5aJL15t9J9JPZpYOple6lrkvAm4eAnH6tSIvZe3IYgo2YVjIA0Ii2aXpVpHCWupyIMo6P14AwJ4rmTNEUiuZE0Zw8r_9-36PjD7YikGcBlVHcYTZ3ZaEFBP0n9R7XYayS</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1115065594</pqid></control><display><type>article</type><title>Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Biber, Roland ; Brem, Matthias ; Singler, Katrin ; Moellers, Manfred ; Sieber, Cornel ; Bail, Hermann Josef</creator><creatorcontrib>Biber, Roland ; Brem, Matthias ; Singler, Katrin ; Moellers, Manfred ; Sieber, Cornel ; Bail, Hermann Josef</creatorcontrib><description>Purpose
Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches.
Methods
We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with self-centring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.
Results
After a dorsal approach 10.5 % [confidence interval (CI) 7.7–13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7–13.6 %), which was not significantly different (
p
= 0.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2–5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0–1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5–8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2–2.2 %). The frequency of the other types of complications did not significantly differ.
Conclusions
The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.</description><identifier>ISSN: 0341-2695</identifier><identifier>EISSN: 1432-5195</identifier><identifier>DOI: 10.1007/s00264-012-1624-4</identifier><identifier>PMID: 22872411</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - methods ; Bone Malalignment - epidemiology ; Bone Malalignment - etiology ; Cementation ; Female ; Femoral Neck Fractures - physiopathology ; Femoral Neck Fractures - surgery ; Germany - epidemiology ; Hematoma - epidemiology ; Hematoma - etiology ; Hemiarthroplasty - adverse effects ; Hemiarthroplasty - methods ; Hip Joint - physiopathology ; Hip Joint - surgery ; Hip Prosthesis ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - methods ; Original Paper ; Orthopedics ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies ; Treatment Outcome</subject><ispartof>International orthopaedics, 2012-11, Vol.36 (11), p.2219-2223</ispartof><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-f7f8370e14b8d9dd866b25c1eb348c1a487870c64acfdac30c9d936447f195953</citedby><cites>FETCH-LOGICAL-c442t-f7f8370e14b8d9dd866b25c1eb348c1a487870c64acfdac30c9d936447f195953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479273/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479273/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22872411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Biber, Roland</creatorcontrib><creatorcontrib>Brem, Matthias</creatorcontrib><creatorcontrib>Singler, Katrin</creatorcontrib><creatorcontrib>Moellers, Manfred</creatorcontrib><creatorcontrib>Sieber, Cornel</creatorcontrib><creatorcontrib>Bail, Hermann Josef</creatorcontrib><title>Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases</title><title>International orthopaedics</title><addtitle>International Orthopaedics (SICOT)</addtitle><addtitle>Int Orthop</addtitle><description>Purpose
Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches.
Methods
We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with self-centring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.
Results
After a dorsal approach 10.5 % [confidence interval (CI) 7.7–13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7–13.6 %), which was not significantly different (
p
= 0.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2–5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0–1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5–8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2–2.2 %). The frequency of the other types of complications did not significantly differ.
Conclusions
The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Bone Malalignment - epidemiology</subject><subject>Bone Malalignment - etiology</subject><subject>Cementation</subject><subject>Female</subject><subject>Femoral Neck Fractures - physiopathology</subject><subject>Femoral Neck Fractures - surgery</subject><subject>Germany - epidemiology</subject><subject>Hematoma - epidemiology</subject><subject>Hematoma - etiology</subject><subject>Hemiarthroplasty - adverse effects</subject><subject>Hemiarthroplasty - methods</subject><subject>Hip Joint - physiopathology</subject><subject>Hip Joint - surgery</subject><subject>Hip Prosthesis</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Original Paper</subject><subject>Orthopedics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0341-2695</issn><issn>1432-5195</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGKFDEQhoMo7uzqA3iRHL20ptLpTrcHQVZdhQUveg6ZdPV0lkzSproH5h186M0w66IXoSBQ9f9_kvoYewXiLQih35EQslWVAFlBK1WlnrANqFpWDfTNU7YRtYJKtn1zwS6J7oQA3XbwnF1I2WmpADbs96eUyQZ-wEwr8SXbSLuwLlh6dp5zsm7iY8p88jOfcO9tXqac5mBpOb7nNpay4UieeBo52hyO3KX9HLyzi0-RuI-c8ICRT2scMg7FMJTENRddJHTr4g_InSWkF-zZaAPhy4fziv388vnH9dfq9vvNt-uPt5VTSi7VqMeu1gJBbbuhH4aubbeycYDbWnUOrOp0p4VrlXXjYF0tXD_0dauUHste-qa-Yh_OufO63ePgMJZ_BzNnv7f5aJL15t9J9JPZpYOple6lrkvAm4eAnH6tSIvZe3IYgo2YVjIA0Ii2aXpVpHCWupyIMo6P14AwJ4rmTNEUiuZE0Zw8r_9-36PjD7YikGcBlVHcYTZ3ZaEFBP0n9R7XYayS</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Biber, Roland</creator><creator>Brem, Matthias</creator><creator>Singler, Katrin</creator><creator>Moellers, Manfred</creator><creator>Sieber, Cornel</creator><creator>Bail, Hermann Josef</creator><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20121101</creationdate><title>Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases</title><author>Biber, Roland ; Brem, Matthias ; Singler, Katrin ; Moellers, Manfred ; Sieber, Cornel ; Bail, Hermann Josef</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-f7f8370e14b8d9dd866b25c1eb348c1a487870c64acfdac30c9d936447f195953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Bone Malalignment - epidemiology</topic><topic>Bone Malalignment - etiology</topic><topic>Cementation</topic><topic>Female</topic><topic>Femoral Neck Fractures - physiopathology</topic><topic>Femoral Neck Fractures - surgery</topic><topic>Germany - epidemiology</topic><topic>Hematoma - epidemiology</topic><topic>Hematoma - etiology</topic><topic>Hemiarthroplasty - adverse effects</topic><topic>Hemiarthroplasty - methods</topic><topic>Hip Joint - physiopathology</topic><topic>Hip Joint - surgery</topic><topic>Hip Prosthesis</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - adverse effects</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Original Paper</topic><topic>Orthopedics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Biber, Roland</creatorcontrib><creatorcontrib>Brem, Matthias</creatorcontrib><creatorcontrib>Singler, Katrin</creatorcontrib><creatorcontrib>Moellers, Manfred</creatorcontrib><creatorcontrib>Sieber, Cornel</creatorcontrib><creatorcontrib>Bail, Hermann Josef</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Biber, Roland</au><au>Brem, Matthias</au><au>Singler, Katrin</au><au>Moellers, Manfred</au><au>Sieber, Cornel</au><au>Bail, Hermann Josef</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases</atitle><jtitle>International orthopaedics</jtitle><stitle>International Orthopaedics (SICOT)</stitle><addtitle>Int Orthop</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>36</volume><issue>11</issue><spage>2219</spage><epage>2223</epage><pages>2219-2223</pages><issn>0341-2695</issn><eissn>1432-5195</eissn><abstract>Purpose
Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches.
Methods
We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with self-centring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.
Results
After a dorsal approach 10.5 % [confidence interval (CI) 7.7–13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7–13.6 %), which was not significantly different (
p
= 0.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2–5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0–1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5–8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2–2.2 %). The frequency of the other types of complications did not significantly differ.
Conclusions
The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>22872411</pmid><doi>10.1007/s00264-012-1624-4</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International orthopaedics, 2012-11, Vol.36 (11), p.2219-2223 |
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| subjects | Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - methods Bone Malalignment - epidemiology Bone Malalignment - etiology Cementation Female Femoral Neck Fractures - physiopathology Femoral Neck Fractures - surgery Germany - epidemiology Hematoma - epidemiology Hematoma - etiology Hemiarthroplasty - adverse effects Hemiarthroplasty - methods Hip Joint - physiopathology Hip Joint - surgery Hip Prosthesis Humans Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgical Procedures - adverse effects Minimally Invasive Surgical Procedures - methods Original Paper Orthopedics Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Treatment Outcome |
| title | Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases |
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