Palliative Management of Nonoperative Femoral Neck Fractures With Continuous Peripheral Pain Catheters: 20 Patient Case Series. (March 2017) - Rashidifard, Christopher H.
Introduction: To identify the success of pain catheters in the management of pain in nonoperatively treated femoral neck fractures (FNFs) in supplement to current multimodal protocols for end-of-life pain management. Methods: Twenty patients aged older than 50 years with FNFs were selected in a retrospective fashion at a level 1 trauma center. These patients were treated nonoperatively with indwelling continuous peripheral pain catheters to palliate pain. Adjunctive pain control for patients undergoing nonoperative management of FNFs was provided with an indwelling continuous intra-articular/peripheral nerve ropivacaine pain catheters. Pain scores 24 hours before/after continuous pain catheter placement, ambulation status before/after continuous pain catheter placement, mortality at 30 days/1 year, and length of hospital stay were measured. Results: Twenty patients were identified with an average age of 84.55 years. The average length of stay was 4.85 days with a decrease of 4.45 points on the visual analog scale and an improvement of 90% in ambulation status. Thirty-day and one-year mortality were 65% and 95%, respectively. Conclusion: This case series provides orthopedic surgeons with an option for and data on the success of this adjunct to palliate patients who elect to undergo nonoperative management of FNFs. This study also helps define which patients may be candidates for nonoperative management of geriatric hip fractures.