From break to breakdown: Mechanical failures in Icelandic fracture hip surgery (2013-2018)

Abstract

This retrospective study at Landspítalinn University Hospital in Iceland investigates reoperation rates and reasons for fixation failure in hip fracture cases. In our cohort, we evaluated the effectiveness of various surgical techniques and their association with reoperations. Out of 1876 hip fracture cases analyzed between 2013 and 2018, 78 cases required reoperation due to mechanical failure. Our key findings reveal a significant risk of reoperation associated with internal fixation in displaced femoral neck fractures indicating that the use of hemiprosthesis was a more suitable treatment option in these cases. The study also detected an overreliance on dynamic hip screws for trochanteric fractures, particularly in 31. A2 fractures. Moreover, the frequent surpassing of the 25 mm threshold for Tip Apex Distance points to an opportunity for improving fixation stability. These findings emphasize the importance of surgeons adhering to established surgical guidelines and utilizing evidence-based techniques in hip fracture surgeries, aiming to optimize outcomes and reduce the incidence of fixation failure.