Intertrochanteric versus femoral neck hip fractures: differential characteristics, treatment, and sequelae.
BACKGROUND
More than 220,000 persons 65 years and older fracture a hip every year in the United States. Although hip fractures have been considered as a single, homogeneous condition, there are two major anatomic types of proximal femoral fractures: intertrochanteric and femoral neck. The present study's objective was to determine if the two types of hip fracture have different patient characteristics and sequelae.


METHODS
A prospective study of 923 elderly patients admitted to seven Baltimore hospitals for a hip fracture between 1984 and 1986.


RESULTS
Patients with intertrochanteric fractures were slightly older, sicker on hospital admission, had longer hospital stays, and were less likely at 2 months postfracture to have recovered activities of daily living than femoral neck fracture patients. Intertrochanteric fracture patients also had higher mortality rates at 2 and 6 months after fracturing. Long-term recovery (1 year) did not differ between fracture type.


CONCLUSIONS
It appears that intertrochanteric fracture patients have intrinsic factors (older age, poor health) impacting upon their risk of fracture and ability to recover. Differences in patient characteristics and sequelae do exist between femoral neck and intertrochanteric hip fracture patients that impact upon recovery.
Fox
K M
KM
Managed EDGE/EURO RSCG, New York, New York 10016, USA. Kathy.Fox@managededge.com
Magaziner
J
J
Hebel
J R
JR
Kenzora
J E
JE
Kashner
T M
TM
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D015142:Baltimore; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004194:Disease; D005260:Female; D005265:Femoral Neck Fractures / Q000145:classification* / Q000150:complications / Q000601:surgery; D006620:Hip Fractures / Q000145:classification* / Q000150:complications / Q000601:surgery; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D010343:Patient Admission; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D015996:Survival Rate