EARLY POSTOPERATIVE MORTALITY RATES IN ELDERLY PATIENTS WITH INTERTROCHANTERIC FEMORAL FRACTURE: COMPARISON OF THREE FIXATION METHODS

Abstract

Objective: Several surgical options are available for the treatment of elderly intertrochanteric femoral fractures (IFF). This study aimed to compare the mortality rates in the first postoperative month between the intramedullary nail fixation (INF), cemented and cementless hemiarthroplasty (HA). Also, we aimed to analyze the factors that affect the mortality rates within the first postoperative month.Material and Methods: Elderly patients who underwent INF (Group 1), cemented HA (Group 2), and cementless HA (Group 3) for IFF between 2012 and 2020 were selected for the study. Demographic data, pre, and perioperative variables were compared between the three treatment groups. The mortality rates in the first 24 h, 7 days, and 30 days were also compared as well. The patients were divided into survival and non-survival groups according to the outcome in the first postoperative month and factors affecting mortality rates were evaluated.Results: A total of 526 patients were included in the study (194 men and 332 women; mean age, 82.71±6.92 years). The patients who received cemented or cementless HA had higher mortality rates on the first 7 days and 30 days after the operation than those treated with INF (p=0.022; 0.001, respectively). The patients who died within 30 days postoperatively were older (p=0.00) and had more comorbidities (p =0.015) and longer intervals from trauma to surgery (p=0.05) and operation times (p=0.013) than those who survived in the first postoperative month.Conclusion: Intramedullary fixation should be the first option in elderly IFFs. The duration between trauma and surgery and operation time should be shortened to reduce mortality.