Abstract

Pertrochanteric fractures (PFs) in the elderly and their consequences are among the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence. This article aims to determine the functional and radiological outcomes in a group of patients with PFs treated with either the Dynamic hip screw (DHS) or intramedullary Gamma nail fixation. A total of 618 patients, admitted to hospital for pertrochanteric fractures between 2015 and 2019, at a mean age of 82.40 (range 29–104) were screened. Finally, 78 patients were enrolled. Parameters related to hospital stay and surgery (length of hospital stay, surgery duration) were compared in both groups. Functional outcomes were assessed by the Harris hip score, subjective pain was measured with a visual analogue scale (VAS), and quality of life was evaluated using the EQ-5D-5L questionnaire. The obtained results were evaluated at 3- and 6-month follow-up. Radiographic parameters were measured based on the preoperative and postoperative standing anterior–posterior pelvic radiographs and axial projection of the hip at 6-month follow-up. The results showed no significant difference between groups treated either with DHS or intramedullary Gamma nail fixation within the scope of the variables under study. In conclusion, both analysed methods support the functional symmetry of the musculoskeletal system.

Highlights

  • Fractures of the proximal end of the femur, i.e., pertrochanteric fractures (PFs) and fractures of the neck of the femoral bone, are frequent lesions of the femur, which mainly affect elderly patients with osteoporosis and are typically caused by a low-energy trauma such as ground-level falls [1]

  • Based on the demographic characteristics of the test group, we found no significant differences between the two groups in terms of a subjective assessment of health-related quality of life

  • There was a functional symmetry between the outcomes of surgical treatment of PFs in people treated with the dynamic hip screw and intramedullary gamma nail

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Summary

Introduction

Fractures of the proximal end of the femur, i.e., pertrochanteric fractures (PFs) and fractures of the neck of the femoral bone, are frequent lesions of the femur, which mainly affect elderly patients with osteoporosis and are typically caused by a low-energy trauma such as ground-level falls [1]. It is estimated that 87% of fractures in the 65+ age group are caused by falls [4]. PFs occur more frequently in women than in men [5]. The occurrence of diseases especially those related to the cardiovascular system, nervous system, locomotor system, and involution changes associated with the aging process in some cases may lead to the so-called “death spiral” caused by injury. The mortality rate remains very high, up to 30% in the first year after the injury [6]

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