Early failure and mortality following intramedullary fixation of peritrochanteric fractures

Article type: Research Article

Authors: Levi, N. | Gebuhr, P.

Affiliations: Department of Orthopaedic Surgery, Amager Hospital, University Hospital of Copenhagen, Italiensvej 1, Copenhagen 2300 S, Denmark

Note: [] Correspondence to: Niels Levi MD, Ph.D., Vermlandsgade 77, Copenhagen 2300 S, Denmark.

Abstract: Background: The treatment of subtrochanteric and unstable pertrochanteric fractures by operative methods is technically demanding and presents a surgical challenge to the orthopedic surgeon. Fixation failure rates of 5–33% have been reported. However, outstanding results (98% healing) have recently been reported in a large series of 90 fractures treated by one surgeon using an intramedullary Gamma nail. In our department, these fractures are treated by many different surgeons with different levels of surgical training. The aim of this study was therefore to assess our experience with intramedullary fixation of peritrochanteric fractures. Methods: Between January 1998 and December 1999, a total of 37 peritrochanteric fractures were treated with intramedullary fixations. There were 25 women and 12 men. The average age of the patients was 79 years. The 37 operations were performed by 18 different surgeons! (9 registrars and 9 senior registrars or consultants). Results: Two patients were lost to follow‐up. The overall 6 months fixation failure rate was 8/37=22%. The fixation failure rate among survivors at 6 months was 8/20=40%. The 6 months mortality rate was 17/37=46%. Conclusions: It may be wise to refer patients requiring intramedullary peritrochanteric surgery to a specialist.

Keywords: Peritrochanteric fractures, hip, subtrochanteric, intramedullary nail

Journal: International Journal of Risk and Safety in Medicine, vol. 13, no. 2-3, pp. 99-101, 2000