Changes in Patient Pattern and Operation Methods for Intertrochanteric Fractures / 대한정형외과학회잡지

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.