J Korean Orthop Assoc.  2011 Feb;46(1):49-53. 10.4055/jkoa.2011.46.1.49.

Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures

Affiliations
  • 1Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea. shalee@chosun.ac.kr

Abstract

PURPOSE
The purpose
of this study was to analyze characteristics of femur intertrochanteric fractures concerning age, fracture pattern, and change in operation method, retrospectively.
MATERIALS AND METHODS
Of the patients over 65 years of age that had been treated between June 1999 and June 2007, two hundred forty patients, who were available for follow-up for at least 1 year were selected. Patients were divided into 2 groups, A or B, based on their time of operation during a 4-year period. Age, bone marrow density (BMD), causes of fracture, fracture patterns, and treatment trends were analyzed.
RESULTS
The number of patients in group A was 108 and in group B was 132; the mean age was 75.38 years and 77.58 years, retrospectively with the mean age increased by 2.2 years. In group A, 44 cases (40%) were comminuted fractures over AO type A2-2, 77 cases (71%) were unstable fracture using Evans classification; in group B, there were 65 cases (49%) and 100 cases (76%), respectively. Based on the BMD analysis, an average -0.29 decreased in group B. In group A, 61 cases (56%) were treated with compressive hip screw, 41 cases (38%) with proximal femoral nail , 6 cases (6%) with bipolar hemiarthroplasty. In group B, 48 cases (36%) were treated with compressive hip screw, 73cases (55%) with proximal femoral nail, and 11 cases (9%) with bipolar hemiarthroplasty.
CONCLUSION
There were increases in patient age, percentages of unstable fractures, fracture comminution and decrease in bone marrow density. The use of proximal femoral nail or primary arthroplasty increased.

Keyword

femur; intertrochanteric fracture; operative treatment
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