Selection of operative method and peri-operative managements for osteoporotic femoral intertrochanteric fracture in elderly patients aged 75 years and over

Objective To investigate the selection of operative method and peri-operative managements for osteoporotic femoral intertrochanteric fracture in elderly patients aged over 75 years. Methods A total of 132 consecutive patients aged 75-91 years with osteoporotic intertrochanteric fractures from July 2009 to July 2012 were retrospectively analyzed. 47 patients were treated with dynamic hip screw (DHS group), 44 patients with proximal femoral nail anti-rotation (PFNA group) and 41 patients with Gamma Ⅲ nail (Gamma Ⅲ group). The peri-operative managements, operation circumstance, the time for fracture union, postoperative complications and the degree of functional recovery were analyzed and compared between the 3 groups. Results The mean surgical time was shorter in Gamma Ⅲ nail and PFNA groups than in DHS group 〔(68.7±9.1) min, (80.5±11.3) min vs. (112.2±18.4) min, both P 0.05). There were significant differences in postoperative complications between Gamma Ⅲ nail, PFNA groups and DHS group (2 cases, 3 cases vs. 11 cases, P 0.05). Conclusions The 3 operative methods for stable intertrochanteric fracture are feasible and effective in elderly patients, but for unstable intertrochanteric fractures, the treatment with Gamma Ⅲ nail and PFNA has advantages. Key words: Femoral fractures; Internal fixatiors