Trochanteric fractures. Mobility, complications, and mortality in 607 cases treated with the sliding-screw technique.
Six hundred seven trochanteric fractures (563 patients) were treated with a sliding-screw technique and followed clinically and roentgenographically for at least one year. Of 351 patients admitted from their homes, 209 (60%) were discharged to their homes after an average of 18 days in the hospital. During the first year another 61 (17%) patients returned home after rehabilitation in a geriatric ward. Of 446 patients walking without support or with one cane before surgery, 360 (80%) had regained the same mobility after one year. The one-year mortality rate was 18%, while the ten-year rate was 74%. Compared with a control cohort, the mortality rate was increased during the first two years after fracture. The increase in mortality was influenced by advanced age, admission from long-term care institutions, male gender, and ambulatory or nonambulatory status before surgery. Forty-five (7.4%) were reoperated, 17 because of technical complications, three because of infection, and three because of nonunion. No further nonunions occurred. The deep infection rate was nine of 339 (2.7%) before and two of 268 (0.8%) after the introduction of antibiotic prophylaxis. Thromboembolic complications decreased from 4.1% to 1.2% after the introduction of dextran 70 as thromboembolic prophylaxis.
Department of Orthopedics, University Hospital, Umeå, Sweden.
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Larsson
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Friberg
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Hansson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D003911:Dextrans / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control
D003911:Dextrans