Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures

Dong-Hui Kim; Sang-Hong Lee; Sang-Ho Ha; Jae-Won You

doi:10.4055/jkoa.2011.46.1.49

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Kim, Lee, Ha, and You: Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2011; 46(1): 49-53.

Published online: 23 February 2011

DOI: https://doi.org/10.4055/jkoa.2011.46.1.49

Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures

Dong-Hui Kim, M.D., Sang-Hong Lee, M.D., Sang-Ho Ha, M.D., Jae-Won You, M.D.

Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.

Correspondence to: Sang-Hong Lee, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 588, Seosuk-dong, Dong-gu, Gwangju 501-717, Korea. TEL: +82-62-220-3147, FAX: +82-62-226-3379, shalee@chosun.ac.kr

Received 11 March 2010 Accepted 10 September 2010

(open-access):

"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited."

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.

Keywords: femur, intertrochanteric fracture, operative treatment

Figures and Tables

Figure 1

Changes in age of patients.

Figure 2

Changes in operation method.

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