Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty

ABSTRACT

Purpose: To compare the postoperative survival and mortality rates in intertrochanteric femoral fracture (IFF) patients who underwent either open reduction internal fixation (ORIF) or hip arthroplasty. Methods: Clinical data from senior patients who had IFF and underwent ORIF or hip arthroplasty were analyzed retrospectively. Survival curves were compared between groups with Kaplan–Meier method and log-rank test. Significant independent prognostic factors were identified by Cox multivariate regression analysis. Results: All patients recovered fully post-surgery. Although 31 patients died during the follow-up period (ORIF, mean 45.4 months; arthroplasty, mean 51.6 months), mortality rate did not differ significantly between the groups. The 1-yr and 2-yr survival rate estimates for the ORIF group were 92.2%, and 86%, respectively; they were 85% and 74% for the arthroplasty group. Average survival lengths for ORIF and arthroplasty groups were 88 and 67 months, respectively. The effect of surgical approaches on survival differed significantly (log-rank test c2 = 6.402, p = 0.011). Multivariate Cox regression model indicated that surgical choice (p = 0.036) was a significant independent risk factor for the prognosis of senile IFF, even with adjustment for age (p = 0.002). Conclusion: The overall postoperative prognosis was superior in senile IFF patients treated with ORIF.

Keywords::

• Intertrochanteric femoral fracture
• survival rate
• mortality
• open reduction
• internal fixation
• hip arthroplasty

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Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

FUNDING

This research is supported by the National Natural Science Foundation of China (81572171), the Doctoral Start-up Project Grant of the Natural Science Foundation of Guangdong Province, China (2014A030313185), the Science and Technology Planning Project of the Guangdong Province (2013B02180119) and the Doctoral Start-up Project Grant of the Natural Science Foundation of Guangdong Province, China (2015A030310204) respectively.