The relationship between the type of unstable intertrochanteric femur fracture and mobility in the elderly

Abstract

BackgroundThe purpose of this study was to assess the impact of uniform anti-rotational proximal femoral intramedullary nail (APFN) use on patient mobility status with the treatment of two different unstable intertrochanteric femur fracture groups of geriatric patients.MethodsThe study included patients aged > 65 years who underwent surgery with APFN. Group 1 comprised AO classification, AO/OTA 31-A22, and A23 patients, and group 2, A31 and A32 patients. The demographic data of the patients, postoperative complications, follow-up, mortality status, postoperative reduction, tip-apex distance (TAD), and the Parker-Palmer mobility (PPM) score were evaluated.ResultsThere were no statistically significant differences between the groups in terms of gender, affected side, time from trauma to surgery, ASA score, anesthesia type, duration of hospitalization, duration of surgery, TAD values, reduction values, or mortality rate. The average age of patients in group 2 was significantly higher than that of patients in group 1 (p < 0.05). The mobility scores of group 1 patients were significantly higher than those of group 2 (p < 0.05).ConclusionsWhile no relationship was found between the TAD values and the reduction status of the cases, the PPM scores of the AO 31 A3 cases were determined to be significantly worse. Therefore, fractures with a preoperative classification of AO type 31 A3 can be expected to have worse results than A2 ITF fractures. The fracture type seems to have as great an effect as other factors on the postoperative mobility score.

Evaluation of the clinical efficacy of 3D Printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in the treatment of Senile Intertrochanteric Fractures

“… 9 With the increasingly serious aging of the population, the incidence rate is increasing year by year. 11 The higher disability rate is caused by intertrochanteric fractures, so that the quality of life of patients is seriously affected and the survival rate is greatly reduced. 12 Despite a relatively abundant intertrochanteric blood circulation and easier healing after treatment, serious pathological consequences may be caused to patients due to unsatisfactory reduction and healing.…”

Intracortical Screw Insertion Plus Limited Open Reduction in Treating Type 31A3 Irreducible Intertrochanteric Fractures in the Elderly

“…Since osteoporosis is a prevalent condition in elderly patients, greater importance should be attached to reduction. Forcible screw insertion with poor reduction will nally lead to a dramatic increase in the risk of internal xation [4,10,14]. Therefore, the authors abandoned closed reduction and performed limited open reduction instead to expose the broken end directly.…”

“…Therefore, limited open reduction is recommended if closed reduction is ineffective for irreducible intertrochanteric fractures [5,[11][12][13][14][15][16], typically type 31A3 fractures as discussed in the present study.…”

A novel three-dimensional classification system for intertrochanteric fractures based on computed tomography findings

“…Osteosynthesis has been widely used for intertrochanteric fractures (2). However, it is not always possible for elderly patients with unstable fractures to have good outcomes after osteosynthesis (3,4). To address this problem, both improvement of surgical technique and advances in implant technology have been promoted (5)(6)(7)(8)(9).…”