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

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 wer...

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Published in:Journal of investigative surgery 2018-09, Vol.31 (5), p.431-437
Main Authors: Yang, Zi-Bo, Wu, Pei-Hui, Wong, Ping-Kwan, Huang, Zhi-Yu, Fu, Ming, Liao, Wei-Ming, He, Ai-Shan, Kang, Yan
Format: Article
Language:English
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Summary: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.
ISSN:0894-1939
1521-0553
DOI:10.1080/08941939.2017.1333177