{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:24:25Z","timestamp":1774981465411,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The outcomes of patients with pathologic hip fractures remain unclear. Data from a large international geriatric trauma registry were analyzed to examine the outcomes of patients with pathologic hip fractures compared with patients with typical osteoporotic hip fractures. Materials and Methods: Data from the Registry for Geriatric Trauma of the German Trauma Society (Deutsche Gesellschaft f\u00fcr Unfallchirurgie (DGU)) (ATR-DGU) were analyzed. All patients treated surgically for osteoporotic or pathologic hip fractures were included in this analysis. Across both fracture types, a 2:1 optimal propensity score matching and multivariate logistic regression analysis were conducted. In-house mortality rate and mortality at the 120-day follow-up, as well as mobility after 7 and 120 days, reoperation rate, discharge management from the hospital and readmission rate to the hospital until the 120-day follow-up were analyzed as outcome parameters for the underlying fracture type\u2014pathologic or osteoporotic. Results: A total of 29,541 cases met the inclusion criteria. Of the patients included, 29,330 suffered from osteoporotic fractures, and 211 suffered from pathologic fractures. Multivariate logistic regression analysis revealed no differences between the two fracture types in terms of mortality during the acute hospital stay, reoperation during the initial acute hospital stay, walking ability after seven days and the likelihood of being discharged back home. Walking ability and hospital readmission remained insignificant at the 120-day follow-up as well. However, the odds of passing away within the first 120 days were significantly higher for patients suffering from pathologic hip fractures (OR: 3.07; p = 0.003). Conclusions: Surgical treatment of pathologic hip fractures was marked by a more frequent use of arthroplasty in per- and subtrochanteric fractures. Furthermore, the mortality rate among patients suffering from pathologic hip fractures was elevated in the midterm. The complication rate, as indicated by the rate of readmission to the hospital and the necessity for reoperation, remained unaffected.<\/jats:p>","DOI":"10.3390\/medicina58070871","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T22:43:28Z","timestamp":1656542608000},"page":"871","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Surgical Management and Outcomes following Pathologic Hip Fracture\u2014Results from a Propensity Matching Analysis of the Registry for Geriatric Trauma of the German Trauma Society"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4666-3187","authenticated-orcid":false,"given":"Christopher","family":"Bliemel","sequence":"first","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery, University Hospital Giessen-Marburg, Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Rascher","sequence":"additional","affiliation":[{"name":"Akademie der Unfallchirurgie GmbH, 80538 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludwig","family":"Oberkircher","sequence":"additional","affiliation":[{"name":"Department of Trauma Surgery, Orthopaedics and Arthroplasty, Hospital Friedrichshafen, 88048 Friedrichshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Schlosshauer","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Agaplesion Evangelical Hospital Giessen, 35398 Gie\u00dfen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-1616","authenticated-orcid":false,"given":"Carsten","family":"Schoeneberg","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital Essen, 45131 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9166-0965","authenticated-orcid":false,"given":"Matthias","family":"Knobe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Cantone Hospital Lucerne,6004 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Pass","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital Essen, 45131 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Ruchholtz","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery, University Hospital Giessen-Marburg, Baldingerstrasse, 35043 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0819-4706","authenticated-orcid":false,"given":"Antonio","family":"Klasan","sequence":"additional","affiliation":[{"name":"Department for Orthopaedics and Traumatology, Kepler University Hospital Linz, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the AltersTraumaRegister DGU","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1007\/s00264-017-3591-2","article-title":"The impact of pre-existing conditions on functional outcome and mortality in geriatric hip fracture patients","volume":"41","author":"Bliemel","year":"2017","journal-title":"Int. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.arth.2020.01.003","article-title":"Pathologic Versus Native Hip Fractures: Comparing 30-day Mortality and Short-term Complication Profiles","volume":"35","author":"Amen","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Guzik, G. (2018). Oncological and functional results after surgical treatment of bone metastases at the proximal femur. BMC Surg., 18.","DOI":"10.1186\/s12893-018-0336-0"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00402-020-03586-1","article-title":"More than a reposition tool: Additional wire cerclage leads to increased load to failure in plate osteosynthesis for supracondylar femoral shaft fractures","volume":"141","author":"Bliemel","year":"2020","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0021-9290(01)00040-9","article-title":"Hip contact forces and gait patterns from routine activities","volume":"34","author":"Bergmann","year":"2001","journal-title":"J. Biomech."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00402-014-2111-8","article-title":"Distal femoral fractures in the elderly: Biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model","volume":"135","author":"Bliemel","year":"2014","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1016\/j.injury.2016.10.013","article-title":"Impact of cement-augmented condylar screws in locking plate osteosynthesis for distal femoral fractures\u2014A biomechanical analysis","volume":"47","author":"Bliemel","year":"2016","journal-title":"Injury"},{"key":"ref_8","first-page":"1","article-title":"Cement augmentation of an angular stable plate osteosynthesis for supracondylar femoral fractures-biomechanical investigation of a new fixation device","volume":"21","author":"Klasan","year":"2020","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1055\/s-0031-1298299","article-title":"Subsequent treatment following proximal femoral fracture\u2014Who, when, where? Assessment of the current situation in Germany","volume":"150","author":"Bliemel","year":"2012","journal-title":"Z. Orthop. Unfall."},{"key":"ref_10","first-page":"180","article-title":"Surgical treatment of proximal femoral fractures\u2014A training intervention?","volume":"151","author":"Bliemel","year":"2013","journal-title":"Z. Orthop. Unfall."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1007\/s00198-015-3472-8","article-title":"Pre-fracture quality of life predicts 1-year survival in elderly patients with hip fracture\u2014Development of a new scoring system","volume":"27","author":"Bliemel","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Liener, U., Becker, C., and Rapp, K. (2018). Weissbuch Alterstraumatologie, Verlag W. Kohlhammer.","DOI":"10.17433\/978-3-17-034361-0"},{"key":"ref_13","unstructured":"Liener, U., Becker, C., Rapp, K., Raschke, M., Kladny, B., and Wirtz, D. (2021). Weissbuch Alterstraumatologie und Orthogeriatrie, Verlag W. Kohlhammer."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1002\/jso.25669","article-title":"Trends in the surgical treatment of pathological proximal femur fractures in the United States","volume":"120","author":"Varady","year":"2019","journal-title":"J. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1245\/s10434-015-4881-9","article-title":"Complications and Postoperative Mortality Rate After Surgery for Pathological Femur Fracture Related to Bone Metastasis: Analysis of a Nationwide Database","volume":"23","author":"Tsuda","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/CORR.0000000000001038","article-title":"Is Delayed Time to Surgery Associated with Increased Short-term Complications in Patients with Pathologic Hip Fractures?","volume":"478","author":"Varady","year":"2020","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"AUC\u2014Akademie der Unfallchirurgie, and Arbeitskreis AltersTraumaRegister DGU\u00ae (2019). The geriatric trauma register of the DGU-current status, methods and publication guidelines. Unfallchirurg, 122, 820\u2013822.","DOI":"10.1007\/s00113-019-0698-5"},{"key":"ref_18","first-page":"619","article-title":"Results of the pilot phase of the Age Trauma Registry DGU\u00ae","volume":"120","author":"Hartwig","year":"2017","journal-title":"Unfallchirurg"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v042.i08","article-title":"MatchIt: Nonparametric Preprocessing for Parametric Causal Inference","volume":"42","author":"Ho","year":"2011","journal-title":"J. Stat. Softw."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1198\/106186006X137047","article-title":"Optimal Full Matching and Related Designs via Network Flows","volume":"15","author":"Hansen","year":"2006","journal-title":"J. Comput. Graph. Stat."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1111\/j.1532-5415.1999.tb05204.x","article-title":"Detection of Older People at Increased Risk of Adverse Health Outcomes After an Emergency Visit: The ISAR Screening Tool","volume":"47","author":"McCusker","year":"1999","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1007\/s11999-011-2038-0","article-title":"Endoprostheses Last Longer Than Intramedullary Devices in Proximal Femur Metastases","volume":"470","author":"Harvey","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1007\/s11999-011-2047-z","article-title":"Endoprosthetic Treatment is More Durable for Pathologic Proximal Femur Fractures","volume":"470","author":"Steensma","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3607","DOI":"10.1016\/j.arth.2017.06.040","article-title":"Durability of Hemiarthroplasty for Pathologic Proximal Femur Fractures","volume":"32","author":"Houdek","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/1120700020938029","article-title":"Survival analysis after hip fracture: Higher mortality than the general population and delayed surgery increases the risk at any time","volume":"30","author":"Barahona","year":"2020","journal-title":"HIP Int."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bliemel, C., Rascher, K., Knauf, T., Hack, J., Eschbach, D., Aigner, R., Oberkircher, L., and AltersTraumaRegister DGU\u00ae (2021). Early Surgery Does Not Improve Outcomes for Patients with Periprosthetic Femoral Fractures\u2014Results from the Registry for Geriatric Trauma of the German Trauma Society. Medicina, 57.","DOI":"10.3390\/medicina57060517"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.1016\/j.arth.2019.06.019","article-title":"Short-Term Morbidity and Mortality After Hemiarthroplasty and Total Hip Arthroplasty for Pathologic Proximal Femur Fractures","volume":"34","author":"Varady","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_28","first-page":"255","article-title":"Early orthogeriatric treatment of trauma in the elderly: A systematic review and metaanalysis","volume":"110","author":"Buecking","year":"2013","journal-title":"Dtsch Arztebl Int."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/871\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:40:45Z","timestamp":1760139645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/7\/871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,29]]},"references-count":28,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["medicina58070871"],"URL":"https:\/\/doi.org\/10.3390\/medicina58070871","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,29]]}}}