The treatment of intertrochanteric fractures comparison of PFN and hemiarthroplasty 3-year mortality study

Abstract

Intertrochanteric fractures in elderly patients can increase mortality due to complications and negative functional results. The aim of this study is to retrospectively compare the follow-up and mortality rates among patients given a proximal femoral nail (PFN), the current routine treatment for these types of fractures, with those given hemiarthroplasty.The study retrospectively investigated 202 patients over the age of 60 who completed at least 3 years of follow-up after hemiarthroplasty or PFN for intertrochanteric fractures between 2007 and 2012. While 132 patients underwent cemented hemiarthroplasty, 70 had PFN. The monitoring duration for those with PFN surgery was 31.25±1.3 months while the duration of follow-up for those with hemiarthroplasty surgery was 20.0±1.2 months. At the end of 3 years of monitoring of the 202 patients, 99 were deceased. There was a statistically significant difference found in terms of patient life expectancy between those with PFN and those with hemiarthroplasty; Cox regression analysis identified that the mortality rate of those with hemiarthroplasty was 5.1 times greater.As a result, patients undergoing hemiarthroplasty should be carefully chosen and if possible, PFN should be preferred. © 2016, Acta Orthopædica Belgica.