[Management of intertrochanteric fractures with lazcano hemiarthroplasty in elderly patients]. / Tratamiento de las fracturas intertrocantéricas con hemiartroplastía tipo Lazcano en el paciente anciano.

OBJECTIVE: To determine if elderly osteopenic patients sustaining an intertrochanteric fracture recover sooner when treated with Lazcano hemiarthroplasty compared with those treated with internal fixation, and whether they can return to their prefracture physical activity level. METHODS: A case-control study was conducted at 1o de Octubre ISSSTE Hospital. Patients over age 70 with intertrochanteric hip fracture and advanced osteopenia were enrolled. The cases were treated with Lazcano hemiarthroplasty and the controls (20 patients) with standard internal fixation (angled plate, DHS system, gamma nail). The comorbid conditions and the prefracture activity level were assessed in both groups. The relation between comorbid conditions and complications was studied and the postoperative activity level of both groups was compared. RESULTS: Thirty patients with these characteristics were included. Ten were cases and 20 were controls. No relation was found between the comorbid conditions and the patients' ability to resume gait postoperatively. Patients treated with hemiarthroplasty walk sooner than those treated with standard internal fixation and have a lower complication rate. CONCLUSIONS: The Lazcano hemiarthroplasty is an excellent choice in the treatment of intertrochanteric fractures in osteopenic patients. Long-term studies with more patients are required to assess the presence of complications.