{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:14:45Z","timestamp":1763018085940,"version":"3.37.3"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T00:00:00Z","timestamp":1565568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Large scale data on the treatment of pathologic proximal femur fractures (PPFFs) are lacking. The purpose of this study was to evaluate trends in patient demographics, complication rates, and relative utilization rates of various techniques associated with PPFFs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The American College of Surgeons\u2010National Surgical Quality Improvement Program (NSQIP) database was queried for PPFFs from 2009 to 2017. Patient demographics, 30\u2010day complications, and utilization rates were recorded. Trends in these variables were determined over the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most patient demographics did not change during the study period. There were no trends toward decreasing rates of major complications (<jats:italic>P<\/jats:italic>\u2009=\u2009.82), reoperations (<jats:italic>P<\/jats:italic>\u2009=\u2009.65), non\u2010home discharges (<jats:italic>P<\/jats:italic>\u2009=\u2009.17), readmissions (<jats:italic>P<\/jats:italic>\u2009=\u2009.07), or deaths (<jats:italic>P<\/jats:italic>\u2009=\u2009.75); transfusion rates significantly decreased (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Rates of hemiarthroplasty decreased (<jats:italic>P<\/jats:italic>\u2009=\u2009.03) and rates of intramedullary nailing increased (<jats:italic>P<\/jats:italic>\u2009=\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Despite advances in cancer therapeutics, the average PPFF patient has not significantly changed over the past decade. Similarly, most short\u2010term outcomes after PPFF surgery have not improved, demonstrating a need for improved perioperative protocols. Finally, rates of IMN fixation are increasing while rates of HA are falling at NSQIP hospitals. Given that orthopedic oncologists favor endoprosthetic reconstruction in most cases, there may be a need for increased communication between orthopedic oncologists and other members of the orthopedic community treating PPFFs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25669","type":"journal-article","created":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T04:44:45Z","timestamp":1565671485000},"page":"994-1007","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Trends in the surgical treatment of pathological proximal femur fractures in the United States"],"prefix":"10.1002","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8943-0987","authenticated-orcid":false,"given":"Nathan H.","family":"Varady","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bishoy T.","family":"Ameen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre\u2010Emmanuel","family":"Schwab","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3232-2867","authenticated-orcid":false,"given":"Caleb M.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-8188","authenticated-orcid":false,"given":"Antonia F.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Brigham and Women's Hospital Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,12]]},"reference":[{"key":"e_1_2_7_1_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-06-0931"},{"key":"e_1_2_7_1_3_1","unstructured":"National Cancer Institute Bone and joint cancer \u2013 cancer stat facts \u2013 Surveillance Epidemiology and End Results Program (SEER).2018.https:\/\/seer.cancer.gov\/statfacts\/html\/bones.html. 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