Subemergency treatment of femoral intertrochanteric fractures in elderly patients

Objective To investigate the clinical effects of subemergency treatment of femoral intertrochanteric fractures in elderly patients. Methods From June 2013 through February 2014, 47 patients older than 65 years were treated for femoral intertrochanteric fracture at our department and completed full follow-ups. Of them, 20 received subemergency operation. They were 9 men and 11 women, with an average age of 72.2±4.8 years. By the Evans-Jensen classification, there were 2 cases of type I, 5 of type II, 5 of type III, 5 of type IV, and 3 of type V. The time from injury to surgery ranged from 0.5 to 1.7 days (average, 0.8 days). The other 27 patients underwent selective operation. They were 11 men and 16 women, with an average age of 74.9±5.7 years. By the Evans-Jensen classification, there were 3 cases of type I, 6 of type II, 6 of type Ⅲ, 7 of type IV, and 5 of type V. The time from injury to surgery ranged from 2 to 5 days (average, 3.4 days). We compared the 2 groups in terms of in-hospital complications, fracture healing time, length of hospital stay, and hip scores at the last follow-up. Results All the patients were followed up for 12 to 15 months (mean, 13.4 months). The rate of in-hospital complications in the subemergency operation group (35.0%, 7/20) was significantly lower than that in the selective operation group (51.9%, 14/27), and the length of hospital stay in the former (12.1±1.6 days) was significantly shorter than in the latter (16.1±1.8 days) (P 0.05). According to the hip scores at the last follow-up, the subemergency operation group had 16 excellent, 2 good, one fair and one poor cases (with an excellent to good rate of 90.0%) while the selective operation group had 21 excellent, 2 good, 2 fair and 2 poor cases (with an excellent to good rate of 85.2%), showing no significant difference between groups (P>0.05). Conclusion Subemergency operation can reduce not only in-hospital complications but also length of hospital stay for old patients with femoral intertrochanteric fracture. Key words: Hip fractures; Fracture fixation, internal; Operative occasion; Aged