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ORIGINAL RESEARCH article

Front. Surg.
Sec. Orthopedic Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1471101
This article is part of the Research Topic Advances in Surgical and Basic Research in Hip Surgery: Complications, Artificial Intelligence and Surgery Robotics View all articles

Surgical versus Conservative treatment for Hip Osteoporotic Fracture in Maintenance Hemodialysis Patients: a retrospective analysis

Provisionally accepted
Man-Yu Zhang Man-Yu Zhang 1Wei Song Wei Song 1Jing-Bo Wang Jing-Bo Wang 2Rui-Qian Lv Rui-Qian Lv 1Fu-Hao Zhao Fu-Hao Zhao 1Ding-Wei Yang Ding-Wei Yang 1*
  • 1 Department of Nephrology, Tianjin Hospital, Tianjin, China
  • 2 Department of Hip Traumatology, Tianjin Hospital, Tianjin, China

The final, formatted version of the article will be published soon.

    BACKGROUND: Hip Osteoporotic fractures are common complications with high mortality in patients undergoing maintenance hemodialysis (MHD). It remains unclear whether surgical or conservative should be adopted for hip fractures in MHD patients. METHODS: A retrospective analysis was conducted in Tianjin Hospital of Tianjin University from August 2019 to August 2023. A total of 43 MHD patients with hip fracture were included, with 30 cases in the surgical group and 13 cases in the conservative group. The differences in cumulative survival rates, time to first ambulation, Harris score, Barthel index, and incidence of complications were compared. RESULTS: The surgical group had remarkable lower mortality rates as compared with the conservative group at 1, 2, 3, 6, 12, 24 months (13.33 VS. 38.46%, 26.67 VS. 53.85%, 26.67 VS. 53.85%, 26.67 VS. 61.54%, 26.67 VS. 61.54%, and 26.67 VS. 69.23%). In the surgical treatment group, the first ambulation time was reduced to 28 (26) days, which was superior to the conservative group (134.17±43.18 days, P<0.001). The Harris score at 1 month (61.50±4.10) and the Barthel index at 3 months (95, 11.25) were also significantly higher (P＜0.001). Furthermore, the surgical group had a significantly lower overall incidence of complications (60.00 vs. 92.31%, P=0.034). The risk of death and complications of surgical treatment was only 23.0 and 32.4 % of conservative treatment in MHD patients with hip fracture. CONCLUSION: Surgical treatment is effective and safe and should be the first choice for hip fracture in MHD patients.

    Keywords: Maintenance hemodialysis, Osteoporosis, Hip fracture, surgical treatment, hip arthroplasty

    Received: 09 Aug 2024; Accepted: 22 Nov 2024.

    Copyright: © 2024 Zhang, Song, Wang, Lv, Zhao and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ding-Wei Yang, Department of Nephrology, Tianjin Hospital, Tianjin, China

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