Complications and highª²risk factors of internal fixation in elderly patients with intertrochanteric femoral fracture

    ZENG Jianª²Wen, XIE Wen, ZHU Jinª²Yu, BIAN Ziª²Hu, HAN Yiª²Sheng, ZHU Qingª²Sheng

    1Department of Orthopedic Surgery, 2Department of Medical Affairs, Jiangxi Provincial Corps Hospital, Chinese People¬ðs Armed Police Forces, Nanchang 330001, China, 3PLA Orthopedic and Trauma Institute, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China

    ¡¾Abstract¡¿ AIM: To compare the postoperative functional restoration and complication incidence of different therapies in elderly patients with intertrochanteric femoral fracture and to predict the highª²risk factors of the operation. METHODS: One hundred and sixtyª²eight cases of elderly patients with intertrochanteric femoral fractures, who were treated from March, 1995 to June, 2001 were enrolled in the study. Of all the cases, 136 cases received internal fixation therapy and 83 cases were followed up for an average of 37.8 months. According to operative approach, types of fractures and age, the patients were divided into several groups and the therapeutic effects and complications were compared. By calculating composite exponent W of operation risks and mean ages of patients with complications (especially at early stage after operation), the prediction of the operation risk was made. RESULTS: Of the 83 cases, 67 (80.7%) had good functional restoration. Of the 10 (12.0%) cases with complications after operation, 3 cases suffered complications at early stage after operation. The duration and bleeding volume of operation in dynamic hip screw (DHS) internal fixation group were more than those in the other groups (P<0.05). Hospitalization time in intramedullary pin internal fixation group was shorter than that in the other groups. Patients in the group of ages above 70 years had a bad functional restoration. Complication incidence between every two groups had no statistical significance. The average age in the 10 cases with complications was 82 years old. The mean age of 3 cases with early complications was 92 years old, whose exponent W was 6, 7 and 8 respectively. CONCLUSION: Suitable internal fixation materials should be chosen in the therapy of elderly patients with intertrochanteric femoral fractures. DHS, multiª²pin, especially intramedullary pin, can satisfy the needs of fractures of various types for all ages. Age may be a high risk factor in the therapy of elderly patients with intertrochanteric femoral fracture. ......