Musculoskeletal function and quality of life after an unstable trochanteric fracture treated with the trochanteric gamma nail

• Published in: Archives of orthopaedic and trauma surgery 2012-10, Vol.132 (10), p.1495-1503
• Main Authors: Miedel, Ricard, Törnkvist, Hans, Ponzer, Sari, Tidermark, Jan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bone Nails; Female; Fracture Fixation, Intramedullary; Hip Fractures - surgery; Humans; Male; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Osteoporotic Fracture Management; Quality of Life; Recovery of Function; Reoperation
• ISSN: 0936-8051; 1434-3916; 1434-3916
• DOI: 10.1007/s00402-012-1568-6

Purpose The aim of the study was to report the musculoskeletal function and health-related quality of life (HRQoL) after an unstable trochanteric fracture treated with a cephalomedullary nail. Methods One hundred and seventeen patients, mean age 84.1 years, were included in a 1-year prospective cohort study. Outcome measurements included musculoskeletal function according to the Short Musculoskeletal Function Assessment (SMFA) and HRQoL according to the EQ-5D. Results Fourteen patients (12.0 %) were reoperated on, all but one being due to a secondary lag-screw penetration/cut-out. The need for revision surgery was significantly higher after a 4-part fracture according to the Jensen–Michaelsen classification as compared to after a 3-part fracture, i.e. 17 versus 6 % ( p  = 0.048). The reoperation was a hip replacement in 12 of the 14 patients, a total hip replacement (THR) in 10 and a hemiarthroplasty in 2. The SMFA dysfunction and bother indices in all patients showed a significant deterioration at 12 months compared to before the fracture, from 24.8 to 42.4 ( p