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Higher risk of early mortality after fixation seen with unstable vs stable trochanteric hip fracture
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Compared with patients who sustained stable pertrochanteric and intertrochanteric hip fractures, patients who had unstable fractures had higher odds of 6-month and 12-month mortality after surgical fixation, according to the results of this study.
Researchers prospectively collected data on 728 patients who sustained a total of 743 pertrochanteric or intertrochanteric fractures of the hip from a low-injury mechanism and were surgically treated using a dynamic hip screw extramedullary device or intramedullary nail fixation. The mean follow-up was 4 years. Death status of patients and date of death were determined using the Births Deaths and Marriages Register. Investigators determined patient readmissions and reoperations using the public hospital admissions database.
Results showed the odds of mortality were 1.61-times greater for patients with unstable fractures within the first 6 months compared with patients with stable fractures. At 12 months, patients with unstable fractures had a 1.37-times higher risk of mortality vs. patients with stable fractures. Within 12 months, the independent risk factors for early mortality were older age, male gender, high ASA classification, residential care and in-patient reported complications.
Reoperation rates were influenced by the increase in fracture stability at 6 months and 12 months. Investigators noted fixation using the Austofix nail correlated with complications that necessitated device reoperation with 1 year. ‒ by Monica Jaramillo
Disclosures: Chehade reports he received a grant from Stryker Australia Pty Ltd. and the Department of Orthopaedics and Trauma fund. Please see the full study for a list of all other authors’ relevant financial disclosures.
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