Early Surgical Intervention Beneficial for Intracapsular Femoral Fractures

Among patients with intracapsular femoral fractures, early surgical intervention enabled early postoperative mobility and prevented early post-fracture complications, according to study results.

Researchers retrospectively reviewed the electronic medical records of 1,849 patients with proximal femoral fractures treated by internal fixation or femoral head arthroplasty between January 2008 and June 2011. Patients were stratified into three age groups: younger than 50 years, 50 to 70 years and older than 70 years. They were also classified as having either intracapsular or extracapsular proximal femoral fractures.

Sixty-three percent of patients underwent early treatment, defined as treatment within 48 hours from hospital admission, and 37 percent underwent delayed treatment, defined as surgery after 48 hours from admission.

For the first 60 postoperative days, survival rates for the early operated group were 96 percent vs. 93 percent for the delayed group, according to study results. At one year, survival rates were 90 percent for the early operated group and 81 percent for the delayed group.

The researchers found patients with intracapsular fractures had a mortality rate of 11.7 percent for early operation and 22.4 percent for delayed operation vs. 11.85 percent for early operation and 18.4 percent for delayed operation in patients with extracapsular fractures. In both diagnostic groups, the researchers found males had a higher hazard ratio for mortality.