Abstract
Background and Objectives: Intertrochanteric fracture of femur is one of the common injuries in the geriatric population. Despite improvements in management of these patients, mortality rate is more than the expected rate and the patient recovery and regaining the previous level of function fall short of expectation. In this prospective study, we tried to evaluate the mortality rate, locomotion of patients with intertrochanteric fracture and the relationship between the mortality rate and treatment outcome with various factors.
Materials and Methods: During a period of five years between September 1999 and August 2004, 964 patients with intertrochanteric fracture who met our inclusion criteria, underwent surgical treatment and internal fixation. One hundred and twenty four patients were lost of follow up and finally 840 were evaluated.
Results: Among 840 patients with the mean age 69 years (range 50 to 104), 152 died within six months after surgery (18.1%). Among 688 patients who were alive at the end of six-month period, only 420 patients (61%) could regain the prefracture ability to walk. Concerning independent variables there were a significant relationship between age, smoking, ASA score, blood transfusion during surgery and duration of hospitalization with the mortality rate of the patients during six-month period after surgery. On the other hand the age of the patient, sex, prefracture ability to walk, time interval between fracture and admission to hospital and transfusion during surgery were significantly associated with the walking ability of the patients after a six-month period of follow up.
Conclusion: Despite improvements in management of intertrochanteric fractures, mortality rate of these patients is higher than normal population and most of them do not regain the prefracture walking ability. Different factors can affect mortality and outcome of these patients which should be addressed as appropriate.