Anatomical evaluation of proximal femur fractures in trauma patients aged 65 or older admitted to the emergency department

Abstract

Purpose: This retrospective study aimed to assess the association between classification systems for proximal femur fractures and mid-term mortality in elderly patients, focusing on their clinical and anatomical aspects. Materials and methods: Radiological images of patients aged 65 years and older who underwent surgical procedures for proximal femur fractures were reviewed. Various classification systems were applied, including Anatomical, Pipkin, Garden, Evans-Jensen, Seinsheimer, and AO/OTA classifications. Electronic hospital records provided patient data, and statistical analyses were performed. Results: The study included 298 patients, and the mean age was 81.7±7.3 years, and 63.1% were female. Median length of stay in hospital 7 (1-63) days, 19.1% requiring intensive care, and a 13.8% mortality rate within 3 months. Patients were distributed based on anatomical classification, and the distribution of intracapsular and extracapsular fractures according to clinical classifications was detailed. The findings suggest that proximal femur fracture classification systems do not significantly influence mortality rates (p=0.787). Conclusion: Anatomical classification systems may be favored for their simplicity and potential to establish a common language among healthcare professionals. This study provides valuable insights into proximal femur fractures in elderly patients, informing clinical practice.

Keywords

• Anatomy
• classification
• femur
• geriatric
• hip fractures

Acil servise kabul edilen 65 yaş ve üzeri travma hastalarında proksimal femur kırıklarının anatomik değerlendirmesi

Abstract

Amaç: Bu retrospektif çalışma, proksimal femur kırıkları için sınıflandırma sistemleri ile yaşlı hastalarda orta vadeli mortalite arasındaki ilişkiyi değerlendirmeyi amaçlamıştır, odaklanılan nokta ise klinik ve anatomik yönleridir. Gereç ve yöntem: Cerrahi işlem uygulanan proksimal femur kırıklı hastaların radyolojik görüntüleri incelendi. Anatomik, Pipkin, Garden, Evans-Jensen, Seinsheimer ve AO/OTA sınıflandırmaları olmak üzere çeşitli sınıflandırma sistemleri uygulandı. Elektronik hastane kayıtları hastaya ait verileri sağladı ve istatistiksel analizler yapıldı. Bulgular: Çalışma, 298 hastayı içeriyordu ve ortalama yaş 81,7±7,3 yıl idi, %63,1'i kadındı. Hastanede kalış süresi, ortalama 7 (1-63) gün idi, %19,1'i yoğun bakım gerektiriyordu ve 3 ay içinde %13,8'lik bir mortalite oranı görüldü. Hastalar, anatomik sınıflandırmaya göre dağıtıldı ve klinik sınıflandırmalara göre intrakapsüler ve ekstrakapsüler kırıkların dağılımı detaylandırıldı. Bulgular, proksimal femur kırık sınıflandırma sistemlerinin mortalite oranlarını önemli ölçüde etkilemediğini öne sürmektedir (p=0,787). Sonuç: Anatomik sınıflandırma sistemleri, basitliği ve sağlık profesyonelleri arasında ortak bir dil oluşturma potansiyeli nedeniyle tercih edilebilir. Bu çalışma, yaşlı hastalarda proksimal femur kırıkları hakkında değerli içgörüler sağlayarak klinik uygulamayı bilgilendirir.

Keywords

• Anatomi
• sınıflandırma
• femur
• geriatri
• kalça kırıkları

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