Comparison of mid-to-long-term clinical outcomes for stable and unstable femoral intertrochanteric fractures in the elderly managed under orthopedics and geriatric comanagement
Objective:To compare the mid-to-long term clinical outcomes of stable and unstable femoral intertrochanteric fractures in the elderly managed under orthopedics and geriatric comanagement.Methods:A retrospective analysis was conducted on the clinical data of 455 elderly patients with femoral intertrochanteric fractures treated under orthopedics and geriatric comanagement who were admitted to Department of Traumatic Orthopedics,Beijing Jishuitan Hospital,Capital Medical University from May 2015 to April 2017.Patients were divided into a stable fracture group(181 cases)and an unstable fracture group(274 cases)based on preoperative fracture classification.The mortality rate and activity ability of the two groups were recorded and compared,Kaplan-Meier survival curves were drawn,and the mortality rate at the last follow-up was analyzed.Results:All patients were followed up for 36 to 71 months,with an average of(47.8±15.4)months.There was no statistically significant difference in mortality rates between the two groups(all P>0.05)at 3 years post-operation or at the last follow-up.Comparison of the daily activity ability between the two groups at the last follow-up also showed no statistically significant difference(P>0.05).Conclusions:The comanagement of orthopedics and geriatric for the treatment of femoral intertrochanteric fractures in elderly patients resulted in higher mid-to-long-term mortality rates and significantly reduced mobility.The long-term mortality rate and daily activity ability were similar between the two groups of patients.
Hip fractureFemoral intertrochanteric fractureAgedMedium and long-term follow-up