[Surgical results of per- and subtrochanteric femoral fractures. An overview of 15 years].
During the last 15 years, new methods for the surgical approach to pertrochanteric and subtrochanteric fractures were developed (eg. the dynamic hip screw (DHS) and the gamma-nail (GN)). Reviewing the results of this change in methods, we report on 450 patients with pertrochanteric fractures and 102 patients after subtrochanteric fractures of the femur. According to different surgical techniques, the patients were allocated into three periods (1980-1984, period I: 1986-1989, period II; 1991-1993, period III). During period I. 65% of the pertrochanteric fractures were stabilized using Ender-rods, during period III nearly 60% were operated using the DHS and 22% using the gamma-nail. The total hospital stay (department of surgery as well as the geriatric hospital) decreased from 80.4 +/- 31.7 days to 66.6 +/- 24 days (p < 0.001). Serious complications decreased by 80% during this time. During period I, 86.2% of patients with pertrochanteric fractures could be discharged at home, but in 89% in period II and 94.7% during period III. During period I, 74% of the subtrochanteric fractures were stabilized using an angle plate. During period III, more than 30% were operated by using the DHS and nearly 50% by using the gamma-nail. The total hospital stay (department of surgery as well as the geriatric hospital) decreased from 107.5 +/- 46.5 to 78.9 +/- 24.3 days (p < 0.001). During period I, 86.2% of patients with subtrochanteric fractures could be discharged at home, but 100% during period III. Serious complication as well as discharges to nursing home decreased during these 15 years.
Krause
D
D
Geriatrisches Zentrum Hagenhof-Klinik, Langenhagen.
Philipp
J
J
Lucke
C
C
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome