ArticleChinese journal of traumatology = Zhonghua chuang shang za zhi2025
Peri-implant femoral fractures in elderly: Morbidity, mortality, treatment options and good practices.
Article in Chinese journal of traumatology = Zhonghua chuang shang za zhi, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Peri-implant femoral fractures around intramedullary nails: current management strategies and outcomes-a narrative review.Journal of orthopaedic surgery and research · 2025Pooled it
- Predictive value of prognostic nutritional index for the long-term prognosis of elderly patients with fracture: a systematic review and meta-analysis.Frontiers in nutrition · 2025Pooled it
- Microbiological Profile of Periprosthetic Infections Following Femoral Fracture: A Retrospective Analysis.Journal of clinical medicine · 2026Article
- Observational
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7 authors.
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Abstract
purposeFemur fractures are among the most common fractures treated surgically, representing a significant challenge for the orthopedic surgeon. Peri-implant femoral fractures (PIFFs) represent a rare complication of the surgical treatment. It is necessary to pay attention during osteosynthesis, evaluating not only the fracture site but the entire femoral skeletal structure, the characteristics of the fracture, the health comorbidities, and the risk of malunion and pseudarthrosis. There are few studies on the incidence, treatment, and outcomes of PIFFs near osteosynthesis. This study aimed to investigate PIFF after osteosynthesis of femoral fractures and evaluate the mortality after surgery and the morbidity associated with these types of fractures.
methodsA retrospective cohort study was carried out at the IRCCS Galeazzi Orthopedic Institute, Milan, Italy, between January, 2017 and December, 2022. Inclusion criteria were the presence of a femur fracture around an intramedullary nail to treat a previous fracture, follow-up ≥ 12 months, and patients aged ≥ 65 years. Exclusion criterion was intraoperative periprosthetic fractures. The data were expressed as frequency and percentage. Continuous variables were expressed as mean ± standard deviation or median and range.
resultsOverall, 25 patients were enrolled (88.0% female) and the mean age was 84.5 years (range of 70 - 92 years). There were 20 patients having type B PIFF and 5 having type C. In 22 patients, multiple comorbidities were found with an average Charlson comorbidity score of 5.5 and the mean time to peri-implant fracture was 38 months. After surgery, 1 patient (4.0%) presented renal failure, 1 (4.0%) needed removal surgery for their loosening, and 2 (8.0%) presented surgical site infection. Nine patients (36.0%) died within 1 year with a mortality rate of 20.0% at 30 days, 8.0% at 3 months, and 8.0% at 12 months.
conclusionsPIFFs in elderly patients are associated with high short-term mortality and morbidity, so careful planning for primary fracture surgery and patient awareness to ensure prolonged compliance and a healthy lifestyle are essential for prevention.
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