Results of surgical treatment of intertrochanteric and trochanteric fractures in eldery patients

Abstract

Intertrochateric and trochanteric include 52 % out of all femo­ral fractures. More than 91 % of these fractures occur in peo­ple 65 years of age and older. Despite the variety of implants, the number of unsatisfactory treatment outcomes remains high. The fatal outcome due to these fractures is 12–19 % and in­creases with age.Objective: to evaluate the long-term results of metalloesteosynthesis and hip replacement in an improved method in elderly people with intertrochateric and trochanteric lfemoral fractures.Methods: 156 patients aged 61 to 94 years were examined. Joint replacement was performed in 51 patients (study group), metalloesteosynthesis with PFN, DHS, angular and LCP-plates — 105 (control). The Harris score was used to analyze long-term functional results.Results: satisfactory functional results of the treatment were obtained after the PFN and DHS — (75.13 ± 10.14) and (72.83 ± 17.36) respectively. When using angular and LCP plates, treatment was unsatis­factory — (55.71 ± 19.28) and (67.67 ± 19.73) points, respec­tively. In the group of total cement endoprosthesis, the results were evaluated as excellent — (93.0 ± 4.33) points; subtotal bipolar — good (86.53 ± 9.7) points; subtotal monopolar — satisfactory (78.23 ± 7.92) points. The total score of excellent and good results in patients in the study group was 76.47 %, the control group — 35.48 %, the poor — 5.88 % and 64.58 % respectively.Conclusion: hip joint replacement in patients over 61 years of age with intertrochateric and trochanteric fractures of the femur gives the best long-term functional results com­pared to the metalloesteosynthesis.