Observational studyActa orthopaedica2021
How deadly is a fracture distal to the hip in the elderly? An observational cohort study of 11,799 femoral fractures in the Swedish Fracture Register.
Observational study in Acta orthopaedica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Treatment Trade-Offs and Choices for Femoral Fractures: A Systematic Review and Meta-Analysis.Orthopaedic surgery · 2025Pooled it
- Pathological fracture as initial manifestation of malignancy and survival based on diagnoses: a register-based cohort study from the Swedish Fracture Register and the Swedish Cancer Register.Acta orthopaedica · 2026Article
- Clinical outcomes and risk factors in the surgical treatment of distal femur fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Workspace and trajectory-based experimental validation of a 3-armed 6-DOF parallel robot for femoral fracture surgery.Frontiers in robotics and AI · 2026Article
- Associations among resilience, post-traumatic growth, and quality of life in older adults hospitalized with hip fracture: a cross-sectional mediation analysis.Frontiers in physiology · 2026Article
- Proximal and Distal Femoral Fracture. A Longitudinal Retrospective Survival Analysis.Geriatric orthopaedic surgery & rehabilitation · 2026Article
- An Acta Orthopaedica educational article: Femoral neck fractures in adults with emphasis on surgical treatment.Acta orthopaedica · 2025Review
- Secondary surgery and mortality following primary treatment for acetabular fractures - an observational study from Swedish national quality registers.Journal of orthopaedic surgery and research · 2025Observational
- Mortality and reoperations following treatment of acetabular fractures in patients ≥ 70 years: a retrospective cohort study of 247 patients.Acta orthopaedica · 2025Article
- Surgical Timing and Postoperative Outcomes in Distal Femur Fractures: Does Early Intervention Matter?Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Total femoral spanning for distal femur "fragility" fractures utilising nail-plate fixation "short-term experience of a district general hospital".European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Early and 1-year mortality of native geriatric distal femur fractures: A systematic review and time-to-event meta-analysis.Journal of clinical orthopaedics and trauma · 2024Review
- Validation of the Nottingham Hip Fracture Score in Predicting Postoperative Outcomes Following Hip Fracture Surgery.Orthopaedic surgery · 2023Article
- Management of Traumatic Femur Fractures: A Focus on the Time to Intramedullary Nailing and Clinical Outcomes.Diagnostics (Basel, Switzerland) · 2023Article
- Lower mortality in distal femoral fractures in the presence of a knee arthroplasty: an observational study on 2,725 fractures from the Swedish Fracture Register.Acta orthopaedica · 2022Observational
- Malnutrition is Common and Increases the Risk of Adverse Medical Events in Older Adults With Femoral Fragility Fractures.The Iowa orthopaedic journal · 2022Article
- Mortality after Sustaining Skeletal Fractures in Relation to Age.Journal of clinical medicine · 2022Article
- Factors associated with post-operative delirium in hip fracture patients: what should we care.European journal of medical research · 2022Article
- Distal radius fractures in the superelderly: an observational study of 8486 cases from the Swedish fracture register.BMC geriatrics · 2022Observational
- The Swedish Fracture Register - ten years of experience and 600,000 fractures collected in a National Quality Register.BMC musculoskeletal disorders · 2022Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Unlike hip fractures, diaphyseal and distal femoral fractures in elderly patients have not been widely studied. We investigated the demographics, comorbidities and mortality of patients with femoral fractures at any anatomical level with a focus on early mortality.Patients and methods - We analyzed 11,799 patients ≥ 65 years with a femoral fracture registered in the Swedish Fracture Register from 2011 to 2014. The cohort was matched with the National Patient Register to obtain data on comorbidities classified according to the Charlson Comorbidity Index (CCI). Generalized linear models were fitted to estimate the adjusted relative risk of mortality.Results - Mean age of the cohort was 83 years and 69% were women. Patients with distal femoral fractures had the lowest degree of comorbidity, with 9% having a CCI of ≥ 3 compared with 14% among those with proximal and 16% among those with diaphyseal fractures. Unadjusted 90-day mortalities were 13% (95% CI 9.4-16) after fractures in the distal, 13% (CI 10-16) in the diaphyseal, and 15% (CI 14-15) in the proximal segment. The adjusted relative risk for 90-day mortality was 1.1 (CI 0.86-1.4) for patients with distal and 0.97 (CI 0.76-1.2) for patients with diaphyseal femoral fractures when compared with patients with hip fractures.Interpretation - Elderly patients with femoral fractures distal to the hip may have similar adjusted early mortality risks to those with hip fractures. There is a need for larger, preferably prospective, studies investigating the effect of rapid pathways and geriatric co-management for patients with diaphyseal and distal femoral fractures.
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