Intertrochanteric fractures in adults younger than 40 years of age

• Published in: Archives of orthopaedic and trauma surgery 2001, Vol.121 (3), p.123-126
• Main Authors: HWANG, Lin-Chih, LO, Wai-Hee, CHEN, Wei-Ming, LIN, Cheng-Fu, HUANG, Ching-Kuei, CHEN, Chun-Mu
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Biological and medical sciences; Female; Follow-Up Studies; Fracture Fixation, Internal - methods; Fracture Healing - physiology; Fractures; Fractures, Bone - classification; Fractures, Bone - epidemiology; Hip Fractures - classification; Hip Fractures - epidemiology; Hip Fractures - surgery; Humans; Incidence; Injuries; Injuries of the limb. Injuries of the spine; Injury Severity Score; Male; Medical sciences; Multiple Trauma - classification; Multiple Trauma - epidemiology; Probability; Recovery (Medical); Retrospective Studies; Risk Factors; Sex Distribution; Taiwan - epidemiology; Trauma; Traumas. Diseases due to physical agents
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s004020000190

This study reviewed 66 intertrochanteric fractures in patients younger than 40 years old (average 33.0 years old; range 17-40 years old). In contrast to the usual population with intertrochanteric fractures, the factors male predominance (46/66), less pre-injury comorbidity (9/66), more outdoor high energy trauma (47/66), and more associated injuries (32/66) were evident. The distribution of associated injuries was wide. Some of them were life threatening. According to Boyd's classification, 20 were type I, 24 were type II, 13 were type III, and 9 were type IV. Twenty-nine were stable, and 37 were unstable. Stratified by the mechanism of injury, the difference in distribution between the subgroups was significant (p = 0.027, two-tail Fisher's exact test). Simple falls only caused Boyd type I and II fractures. Boyd type III or IV fractures were found more often after vehicular trauma or falls from a height. All the intertrochanteric fractures healed on average 70.5 days (range 31-213 days) after operation. The fractures resulting from vehicular trauma or fall from a height healed significantly more slowly (p = 0.02, univariant log-rank test). There were 6 intertrochanteric fracture-related complications. The mechanism of injury determines the character of intertrochanteric fractures in young adults. Given tougher bone stock, better healing ability, and less co-morbidity, proper management can lead to healing of all intertrochanteric fractures. The extent of functional recovery was also determined by the associated injuries.