Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis

BackgroundHSip 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.MethodsA retrospective analysis was conducted in Tianjin H...

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Main Authors: Man-Yu Zhang, Wei Song, Jing-Bo Wang, Rui-Qian Lv, Fu-Hao Zhao, Ding-Wei Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2024.1471101/full
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author Man-Yu Zhang
Wei Song
Jing-Bo Wang
Rui-Qian Lv
Fu-Hao Zhao
Ding-Wei Yang
author_facet Man-Yu Zhang
Wei Song
Jing-Bo Wang
Rui-Qian Lv
Fu-Hao Zhao
Ding-Wei Yang
author_sort Man-Yu Zhang
collection DOAJ
description BackgroundHSip 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.MethodsA 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.ResultsThe 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.ConclusionSurgical treatment is effective and safe and should be the first choice for hip fracture in MHD patients.
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spelling doaj-art-39d5fd06046f4fa2b881e025e737832c2025-08-20T02:19:33ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-12-011110.3389/fsurg.2024.14711011471101Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysisMan-Yu Zhang0Wei Song1Jing-Bo Wang2Rui-Qian Lv3Fu-Hao Zhao4Ding-Wei Yang5Department of Nephrology, Tianjin Hospital of Tianjin University, Tianjin, ChinaDepartment of Nephrology, Tianjin Hospital of Tianjin University, Tianjin, ChinaDepartment of Hip Traumatology, Tianjin Hospital of Tianjin University, Tianjin, ChinaDepartment of Nephrology, Tianjin Hospital of Tianjin University, Tianjin, ChinaDepartment of Nephrology, Tianjin Hospital of Tianjin University, Tianjin, ChinaDepartment of Nephrology, Tianjin Hospital of Tianjin University, Tianjin, ChinaBackgroundHSip 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.MethodsA 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.ResultsThe 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.ConclusionSurgical treatment is effective and safe and should be the first choice for hip fracture in MHD patients.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1471101/fullmaintenance hemodialysisosteoporosiship fracturesurgical treatmenthip arthroplasty
spellingShingle Man-Yu Zhang
Wei Song
Jing-Bo Wang
Rui-Qian Lv
Fu-Hao Zhao
Ding-Wei Yang
Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
Frontiers in Surgery
maintenance hemodialysis
osteoporosis
hip fracture
surgical treatment
hip arthroplasty
title Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
title_full Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
title_fullStr Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
title_full_unstemmed Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
title_short Surgical vs. conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients: a retrospective analysis
title_sort surgical vs conservative treatment for hip osteoporotic fracture in maintenance hemodialysis patients a retrospective analysis
topic maintenance hemodialysis
osteoporosis
hip fracture
surgical treatment
hip arthroplasty
url https://www.frontiersin.org/articles/10.3389/fsurg.2024.1471101/full
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