Abstract
BackgroundThe study aims to compare the long-term functional and radiographic outcomes of two devices for the treatment of primary intertrochanteric fractures (IFs, OTA 3.1A2.1–A2.3) in elderly patients with osteoporosis.MethodsBetween December 2010 and August 2014, 332 elderly osteoporosis patients with IFs (OTA 3.1A2.1–A2.3) fixed by an InterTAN nail (IT) or a proximal femoral nail anti-rotation (PFNA) device were retrospectively evaluated. Follow-up occurred 1, 3, 6, and 12 months postoperatively and every year thereafter. Mortality was recorded. Patient-related functional and radiographic outcomes were compared. The primary endpoint was the long-term radiographic outcomes. The secondary endpoint was the long-term functional outcomes.ResultsA total of 283 patients (283 hips) with osteoporosis (IT, n = 144; PFNA, n = 139) were evaluated with a mean follow-up period of 38.8 months (range, 36–43 months). No between-group significant differences were noted in the patient demographics, operation variables, and postoperative Harris Hip Score. More radiographic complications were noted in terms of screw cut-out, femoral shaft fracture distal or around the tip of the main nail, and varus collapse of the femoral head in the PFNA group compared with that in the IT group (P < 0.05).ConclusionFor osteoporotic IFs (OTA 3.1A2.1–A2.3) in elderly patients, the use of IT aids in decreasing radiographic complications, but the between-group functional outcomes showed no significant difference.
Highlights
The study aims to compare the long-term functional and radiographic outcomes of two devices for the treatment of primary intertrochanteric fractures (IFs, OTA 3.1A2.1–A2.3) in elderly patients with osteoporosis
General data comparison From December 2010 to August 2014, 283 patients (283 hips) with osteoporotic IFs (OTA 3.1A2.1–A2.3) stabilized with InterTAN nail (IT) or proximal femoral nail anti-rotation (PFNA) devices were enrolled in this study (Figs. 1 and 2, Table 1)
In a series of 225 cases with IFs fixed with a PFNA or IT device, investigators described that varus collapse occurred in 4.9 or 5.5% of cases, respectively (P = 0.95) [14]
Summary
The study aims to compare the long-term functional and radiographic outcomes of two devices for the treatment of primary intertrochanteric fractures (IFs, OTA 3.1A2.1–A2.3) in elderly patients with osteoporosis. The incidence of intertrochanteric fractures (IFs) is increasing [1,2,3]. Because elderly patients have comorbidities, the mortality rate from IFs in these patients is 12 to 41% within 6 months [4, 5]. Most elderly patients following IFs, without osteoporosis, are treated surgically (IT or PFNA) and have good surgical results [7, 8]. Some elderly patients with osteoporotic IFs undergo IT or PFNA processes and are most likely to have poor surgical results [9, 10]. Data from recent studies have confirmed that an increasing number of elderly patients have been presenting
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