{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T19:40:03Z","timestamp":1749930003248,"version":"3.41.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To assess the outcomes of patients who underwent closed reduction and percutaneous pinning (CRPP) with cannulated screws for treatment of a displaced femoral neck fracture (DFNF) as they were deemed too high risk to undergo hemiarthroplasty (HA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Prospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>One urban academic medical center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Sixteen patients treated with CRPP and 32 risk-level\u2013matched patients treated with HA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>CRPP for patients with DFNFs who were deemed too ill to undergo HA. The concept being that CRPP would aid in pain control and facilitate mobilization and if failed, the patient could return electively after medical optimization for conversion to arthroplasty.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurements:<\/jats:title>\n            <jats:p>Complications, readmissions, mortality, inpatient cost, and functional status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The CRPP cohort had a greater incidence of exacerbations of chronic medical conditions or new onset of acute illness and an elevated mean American Society of Anesthesiologist score. There were no differences in discharge location, length of stay, major complication rate, ambulation before discharge, or 90-day readmission rate. Patients undergoing CRPP were less likely to experience minor complications including a significantly decreased incidence of acute blood loss anemia. Three patients (18.7%) in the CRPP cohort underwent conversion to HA or THA. There was no difference in inpatient, 30-day, or 1-year mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>In the acutely ill patients with DFNFs, \u201cdamage control\u201d fixation with CRPP can be safely performed in lieu of HA to stabilize the fracture in those unable to tolerate anesthesia or the sequelae of major surgery. Patients should be followed closely to evaluate the need for secondary surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002104","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T22:25:36Z","timestamp":1628547936000},"page":"e439-e444","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["\u201cDamage Control\u201d Fixation of Displaced Femoral Neck Fractures in High-Risk Elderly Patients: A Feasibility Case Series"],"prefix":"10.1097","volume":"35","author":[{"given":"Sanjit R.","family":"Konda","sequence":"first","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Richmond Hill, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicket","family":"Dedhia","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Rettig","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Davidovitch","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Ganta","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Richmond Hill, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A.","family":"Egol","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY; and"},{"name":"Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, Richmond Hill, NY."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s00590-018-2320-x","article-title":"The evolution and impact of the damage control orthopedics paradigm in combat surgery: a review","volume":"29","author":"Kalinterakis","year":"2019","journal-title":"Eur J Orthop Surg Traumatol."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0002-9610(02)00865-6","article-title":"The timing of fracture treatment in polytrauma patients: relevance of damage control orthopedic surgery","volume":"183","author":"Pape","year":"2002","journal-title":"Am J Surg."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5312\/wjo.v10.i1.1","article-title":"Damage control orthopaedics: state of the art","volume":"10","author":"Guerado","year":"2019","journal-title":"World J Orthop."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1016\/S0140-6736(06)68891-0","article-title":"Osteoporosis","volume":"367","author":"Sambrook","year":"2006","journal-title":"Lancet."},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1097\/BOT.0000000000000291","article-title":"Femoral neck fractures: current management","volume":"29","author":"Florschutz","year":"2015","journal-title":"J Orthop Trauma."},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2106\/JBJS.J.01077","article-title":"Impact of comorbidities on hospitalization costs following hip fracture","volume":"94","author":"Nikkel","year":"2012","journal-title":"J Bone Joint Surg Am."},{"key":"R7-20250614","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.2106\/00004623-200309000-00004","article-title":"Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis","volume":"85","author":"Bhandari","year":"2003","journal-title":"J Bone Joint Surg Am."},{"key":"R8-20250614","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1056\/NEJMcp1611090","article-title":"Management of acute hip fracture","volume":"377","author":"Bhandari","year":"2017","journal-title":"N Engl J Med."},{"key":"R9-20250614","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.injury.2010.06.009","article-title":"One-year outcome for elderly patients with displaced intracapsular fractures of the femoral neck managed non-operatively","volume":"41","author":"Gregory","year":"2010","journal-title":"Injury."},{"key":"R10-20250614","doi-asserted-by":"crossref","first-page":"2309499018803408","DOI":"10.1177\/2309499018803408","article-title":"Outcomes of an accelerated nonsurgical management protocol for hip fractures in the elderly","volume":"26","author":"Lim","year":"2018","journal-title":"J Orthop Surg Hong Kong."},{"key":"R11-20250614","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.injury.2008.01.011","article-title":"Fixation versus hemiarthroplasty for undisplaced intracapsular hip fractures","volume":"39","author":"Parker","year":"2008","journal-title":"Injury."},{"key":"R12-20250614","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/BF00573448","article-title":"Undisplaced femoral neck fracture in the elderly","volume":"115","author":"Chiu","year":"1996","journal-title":"Archives Orthop Trauma Surg."},{"key":"R13-20250614","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0020-1383(95)00157-3","article-title":"Percutaneous pinning in undisplaced subcapital femoral neck fractures","volume":"27","author":"Chiu","year":"1996","journal-title":"Injury."},{"key":"R14-20250614","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.injury.2019.10.068","article-title":"Can we predict failure of percutaneous fixation of femoral neck fractures?","volume":"51","author":"Kane","year":"2020","journal-title":"Injury."},{"key":"R15-20250614","first-page":"298","article-title":"Development of a middle-age and geriatric trauma mortality risk score: a tool to guide palliative care consultations","volume":"74","author":"Konda","year":"2016","journal-title":"Bull NYU Hosp Joint Dis."},{"key":"R16-20250614","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1177\/2151458517735202","article-title":"How does frailty factor into mortality risk assessment of a middle-aged and geriatric trauma population?","volume":"8","author":"Konda","year":"2017","journal-title":"Geriatric Orthop Surg Rehabil."},{"key":"R17-20250614","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1302\/0301-620X.43B4.647","article-title":"Low-angle fixation in fractures of the femoral neck","volume":"43-B","author":"Garden","year":"1961","journal-title":"J Bone Joint Surg Br."},{"issue":"suppl 1","key":"R18-20250614","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification compendium-2018","volume":"32","author":"Meinberg","year":"2018","journal-title":"J Orthop Trauma."},{"key":"R19-20250614","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/BOT.0b013e31813bbcfe","article-title":"Damage control nailing","volume":"21","author":"Higgins","year":"2007","journal-title":"J Orthop Trauma."},{"key":"R20-20250614","doi-asserted-by":"crossref","first-page":"S08","DOI":"10.1055\/s-0037-1606542","article-title":"Role of negative pressure therapy as damage control in soft tissue reconstruction for open tibial fractures","volume":"33","author":"Cherubino","year":"2017","journal-title":"J Reconstr Microsurg."},{"key":"R21-20250614","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.emc.2017.08.011","article-title":"Acute management of the traumatically injured pelvis","volume":"36","author":"Skitch","year":"2018","journal-title":"Emerg Med Clin North Am."},{"key":"R22-20250614","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1308\/rcsann.2016.0111","article-title":"Demystifying damage control in musculoskeletal trauma","volume":"98","author":"Bates","year":"2016","journal-title":"Ann R Coll Surg Engl."},{"key":"R23-20250614","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1097\/MCC.0b013e328359fd57","article-title":"Damage control orthopedics: current evidence","volume":"18","author":"Lichte","year":"2012","journal-title":"Curr Opin Crit Care."},{"key":"R24-20250614","first-page":"1396","article-title":"The early second hit in trauma management augments the proinflammatory immune response to multiple injuries","volume":"62","author":"Tschoeke","year":"2007","journal-title":"J Trauma."},{"key":"R25-20250614","first-page":"602","article-title":"Safety and efficacy of damage control external fixation versus early definitive stabilization for femoral shaft fractures in the multiple-injured patient","volume":"67","author":"Tuttle","year":"2009","journal-title":"J Trauma."},{"key":"R26-20250614","doi-asserted-by":"crossref","first-page":"e000128","DOI":"10.1136\/tsaco-2017-000128","article-title":"Preinjury ASA score as an independent predictor of readmission after major traumatic injury","volume":"2","author":"Tran","year":"2017","journal-title":"Trauma Surg Acute Care Open."},{"key":"R27-20250614","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.amjsurg.2017.09.011","article-title":"Mortality is predicted by Comorbidity Polypharmacy score but not Charlson Comorbidity Index in geriatric trauma patients","volume":"216","author":"Nossaman","year":"2018","journal-title":"Am J Surg."},{"key":"R28-20250614","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/0895-4356(94)90129-5","article-title":"Validation of a combined comorbidity index","volume":"47","author":"Charlson","year":"1994","journal-title":"J Clin Epidemiol."},{"key":"R29-20250614","first-page":"168","article-title":"Percutaneous pinning of intracapsular hip fractures","volume":"33","author":"Bray","year":"1984","journal-title":"Instr Course Lect."},{"key":"R30-20250614","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.2147\/CIA.S174196","article-title":"Hidden blood loss and its risk factors after hip hemiarthroplasty for displaced femoral neck fractures: a cross-sectional study","volume":"13","author":"Guo","year":"2018","journal-title":"Clin Interv Aging."},{"key":"R31-20250614","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/S1521-6896(03)00007-7","article-title":"Orthopaedic surgery in the elderly","volume":"17","author":"Borgeat","year":"2003","journal-title":"Best Pract Res Clin Anaesthesiol."},{"key":"R32-20250614","first-page":"167","article-title":"Anesthetic management of elderly patients aged 90 years or older [in Japanese]","volume":"53","author":"Murakawa","year":"2004","journal-title":"Masui."},{"key":"R33-20250614","doi-asserted-by":"crossref","first-page":"319","DOI":"10.2165\/00002512-199609050-00003","article-title":"Anaesthesia in the elderly. Special considerations","volume":"9","author":"Jones","year":"1996","journal-title":"Drugs Aging."},{"key":"R34-20250614","first-page":"1040","article-title":"Perioperative management of elderly patients over 90 years of age with femoral neck\/trochanteric fracture [in Japanese]","volume":"64","author":"Fujimoto-Ibusuki","year":"2015","journal-title":"Masui."},{"key":"R35-20250614","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.jacc.2014.07.944","article-title":"2014 ACC\/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology\/American Heart Association Task Force on practice guidelines","volume":"64","author":"Fleisher","year":"2014","journal-title":"J Am Coll Cardiol."},{"key":"R36-20250614","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jhsa.2016.10.007","article-title":"Comparison of postoperative complications associated with anesthetic choice for surgery of the hand","volume":"42","author":"Hustedt","year":"2017","journal-title":"J Hand Surg Am."},{"key":"R37-20250614","first-page":"187","article-title":"Ulnar nerve transposition at the elbow under local anesthesia: a patient satisfaction study","volume":"31","author":"Roberti del Vecchio","year":"2015","journal-title":"J Reconstr Microsurg."},{"key":"R38-20250614","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.injury.2007.04.024","article-title":"Subcapital fracture of the femoral neck in medically unwell patients: technique for fixation using direct infiltration local anaesthetic rather than regional blockade","volume":"38","author":"Sher","year":"2007","journal-title":"Injury."}],"container-title":["Journal of Orthopaedic Trauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T19:06:46Z","timestamp":1749928006000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BOT.0000000000002104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/bot.0000000000002104","relation":{},"ISSN":["0890-5339"],"issn-type":[{"type":"print","value":"0890-5339"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"2021-03-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}