J Korean Fract Soc.  2013 Jul;26(3):199-204. 10.12671/jkfs.2013.26.3.199.

Morbidity and Mortality of the Elderly after Early Operation for Trochanteric Fractures

• Jang SA
• Cho YH
• Byun YS
• Park KH
• Yoo HS
• Jung C

• KMID: 1431664
• DOI: http://doi.org/10.12671/jkfs.2013.26.3.199

Abstract

PURPOSE
To find out the effect of early closed reduction and internal fixation (within 24 hours after admission to hospital) on the morbidity and mortality in the elderly with intertrochanteric fractures of the femur.
MATERIALS AND METHODS
Retrospectively, we analyzed 99 patients with intertrochanteric fracture of the femur who underwent surgery from January, 2009 to December, 2010. We reviewed 89 of the 99 patients and checked for early complications and reviewed the mortality rates 3 months, 6 months and 1 year after surgery. There were 24 males and 65 females. The average age was 79.8 years (61-99 years). According to the American Society of Anesthesiologists classification, 25 patients were class 1, 37 patients were class 2, 26 patients were class 3, and 1 patient was class 4. All patients were operated on by one surgeon, who was skilled in inserting intramedullary nail.
RESULTS
The average surgical time was 43 minutes and the average intraoperative blood loss was 165 ml. Sixteen patients experienced delirium but all of them recovered. One patient had pneumonia at one month after surgery. Pressure sores developed in one patient but improved with conservative treatment. Pulmonary thromboembolism developed in some patients one month after surgery. Three patients (3.4%) died within three months and one patient (1.1%) died between three and six months after surgery, but no patient died between six months and one year after surgery.
CONCLUSION
If patients are optimized for the operation, early internal fixation of trochanteric fracture in elderly patients after arrival at the hospital should be considered to reduce early complications and mortality.

Keyword

Femur; Trochanteric fractures; Early operation; Morbidity; Mortality

MeSH Terms

Aged
Delirium
Female
Femur
Hip Fractures
Humans
Male
Operative Time
Pneumonia
Pressure Ulcer
Pulmonary Embolism
Retrospective Studies

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