title: Internal fixation versus conservative treatment for elderly patients with a trochanteric hip fracture in conjunction with post-stroke hemiplegia.
abstract: OBJECTIVE
  To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture.
  
  
  METHODS
  The patients were obtained consecutively from January 2005 to December 2010 with inclusion criteria. The total number was 138 and allocated to two groups: treated with the Gamma nail (n=72,group A) and continuous skin traction (n=66,group B). Preoperative variables including patient age, gender, duration of cerebrovascular accident, duration of hypertension, ASA risk score, Harris hip score and fracture type were recorded and compared. After treatment, time of patients activity on the bed, ambulation time, Harris hip score, mortality, complications were recorded and used to compare the outcomes.
  
  
  RESULTS
  (1) Follow-up was undertaken from 3 to 10 years, with an average of 5.8 years. (2) No statistical difference in preoperative variables was found between the 2 groups. (3) two groups had statistical significance (P=0.000) in the time of patients activity on the bed and ambulation time and group A can activities on the bed and ambulates earlier. (4) There were significant differences between 2 groups in Harris hip score at 1 and 3 years and group A was significantly higher than group B. (5) there were statistically significant differences in mortality of 3 years, 5 years and 10 years and the group B was significantly higher than the group A. (6) There was a statistical significance in complications between 2 groups and group B was higher than group A. Major complications in group A were pain, lag screw cut out, implant infection and distal femoral fractures caused by fall after the surgery.
  
  
  CONCLUSIONS
  On elderly patients with trochanteric hip fracture on the hemiplegic lower side, Gamma nail internal fixation treatment can achieve better effect, patients can be early activity, fewer complications, and less mortality.
authors.affiliation: Department of Orthopedic, The Affiliated Hospital Of Chengdu University, Number 82, North 2 Section, 2nd Ring Road, Chengdu City, Sichuan Province 610081, China. Electronic address: likainan1961@126.com.
authors.forename: Kainan
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Orthopedic, The Affiliated Hospital Of Chengdu University, Number 82, North 2 Section, 2nd Ring Road, Chengdu City, Sichuan Province 610081, China.
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D001858:Bone Nails; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing; D006429:Hemiplegia / Q000150:complications* / Q000503:physiopathology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Gamma nail; continuous skin traction; elderly patients, post-stroke hemiplegia; trochanteric hip fracture