Evaluating National Trends in Hip Fracture Management

    Is there a preferred surgical option for managing hip fracture patients in the US – and has it changed over time?
    To find out, Luis C. Grau, MD, and his colleagues from the University of Miami in Florida conducted a retrospective analysis of data from the National Hospital Discharge Survey (NHDS) registry.

    They identified more than 4.7 million patients who had sustained a femoral neck, peritrochanteric/intertrochanteric, or subtrochanteric hip fracture between 1990 and 2007 and had undergone 1 of the following surgical treatments:

    • Open reduction internal fixation
    • Hemiarthroplasty
    • Total hip arthroplasty (THA)
    • Internal fixation without reduction of the femur
    • Closed reduction internal fixation of the femur   

    Dr. Grau, who presented the study findings at ICJR’s Pan Pacific Orthopaedic Congress, said they noted a steep decline – by 40% – in THA procedures for femoral neck fractures between 1990 and 2007. The number of hemiarthroplasty procedures also decreased, but only by 3%.

    At the same time, closed reduction internal fixation increased by a staggering 350%.

    Medical and surgical complications significantly increased during the study period, which Dr. Grau said may be attributable to increasing patient age and co-morbidities.

    He and his colleagues concluded that, “This cohort (of hip fracture patients) continues to change; therefore, surgeons should consider age and preoperative risk factors in their surgical planning, implant selection, and perioperative management in order to minimize the risk for unfavorable outcomes.”

    Click the image above to hear Dr. Grau’s comments on the study.


    Grau L, Massel, D, Summers S, Zych G, Ong A, Hernandez V. Operative trends in the treatment of hip fractures and the role of total hip arthroplasty. Presented at the 3rd Annual Pan Pacific Orthopaedic Congress, August 10-13, 2016, in Kona, Hawaii.