The Patterns and Trends in the Surgical Fixation Modalities of Intertrochanteric Femoral Fractures

Abstract

Objectives: To study the Intertrochanteric fractures patterns, distributions, and fixations modalities. In addition to assessing orthopedic surgeons’ tendencies toward implant choices according to the fracture morphology. Methods: This descriptive study reviewed the clinical and radiological records of 574 admitted with intertrochanteric femoral fractures in two hospitals of Jordanian Royal Medical Services from January - 2017 to December – 2020. Utilizing Picture Archiving and Communication System (PACS), patients’ radiographs were evaluated regarding the fracture patterns, surgical fixation technique, and indications. Results: Females accounted for 59.1% of patients. The mean age was equal to 76.40 ± 11.65 years, with an age range of 82 years (20 – 102 years). Comorbidities were found in 65.3% of patients. The majority of the fractures (54.5%) were of a simple fracture pattern, and the Dynamic Hip Screw (DHS) was the most commonly used surgical implant (51.9%). Preoperative mortality accounted for 2.3%. Conclusions: Understanding intertrochanteric femoral fracture patterns and proper implant choice improves outcomes and avoids complications. We found that DHS use was the first choice in stable fracture patterns. However, there is an increasing tendency to use PFN over other modalities in both stable and unstable intertrochanteric fractures. The use of other modalities to treat unstable fracture may be explained by the occasional non-availability of the superior PFN.