Treatment of Intertrochanteric Fracture Using Proximal Femoral Nail for Patients over 90 Years Old

ABSTRACT

PURPOSE: This study examined the clinical and radiologic results of a proximal femoral nail (PFN) used to treat an intertrochanteric fracture of the femur in elderly people more than 90 years of age. MATERIALS AND METHODS: Between January 2005 and December 2008, 20 patients over 90 years old with an intertrochanteric fracture were treated with a PFN. Among them, 16 patients (mean age, 93.9 years; 13 females and 3 males) were followed up for a minimum of 6 months. Clinically, the modified Koval index was evaluated. Radiological bony union and complications were evaluated from the plain X-ray film. RESULTS: The average modified Koval index decreased from 3.1 before surgery to 1.8 after surgery. Only 5 cases could return to their pre-injury status. Radiologic bony union was achieved after an average of 8.2 weeks and there were no complications, such as non-union and femoral head perforations. CONCLUSION: Thirty one percent of patients older than 90 years and treated for an intertrochanteric fracture with a PFN had recovered to their pre-injury ambulatory status. However, all cases showed bony union and no complications. Overall, PFN might be a good treatment option for intertrochanteric fractures in elderly people older than 90 years.