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Evaluation of complications of three different types of proximal extra-articular femur fractures

Differences in complications, age, sex and surviving rates

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Abstract

The comparability of studies of extra-articular proximal femur fractures is compromised by the lack of a widely accepted, simple classification system with clinical and prognostic relevance. The aim of the study is to define the complication profile as well as differences relating to age, gender and survival rate of simple trochanteric fractures, intertrochanteric comminuted and subtrochanteric fractures. Records of 335 consecutive patients were analysed. Patients had a median follow-up of 10 (1–56) months, and were treated operatively with three intramedullary nailing systems. Simple trochanteric fractures (n=67) show wound healing problems (1.5%). Median age is m/f 77(45–98) years/ 85(39–101), and two-year survival rate is m/f 50.3%/ 84.9%. Intertrochanteric comminuted fractures (n=204) show the highest complications (25%), 9.7% femoralhead perforations, 3.5% hardware related problems and 11.8% wound healing problems. Median age is m/f 75(41–94) years/ 85(54–100), survival rate is m/f 92.7%/ 66.5%. Complication rate is 17.0% in subtrochanteric fractures (n=64), no femoralhead perforation but 9.1% other hardware problems and 7.8% wound healing problems. Median age is m/f 72(24–91) years/ 83(38–99), survival rate is m/f 92.3%/ 67.9%. Females show higher complication rates compared to males (19% versus 10%). The three types of fractures show different patterns of complications, survival rates, age, and sex distribution.

Résumé

La comparaison des études sur les fractures extra-articulaires de l’extrémité supérieure du fémur sont compromises par l’absence d’une classification clinique et pronostique simple et largement acceptée. Le but de cette étude était de définir le profil des complications ainsi que les différences selon l’âge, le sexe, le taux de survie pour les fractures trochantériennes simple, les fractures intertrochantériennes comminutives et les fractures sous trochantériennes. Une série de 335 patients consécutifs, traités avec 3 systèmes de clou centro- médullaires, était analysée prospectivement avec un suivi median de 10 mois (1–56). Les fractures trochantériennes simple (n=67) avaient des problèmes de cicatrisation des parties molles (1,5%); respectivement Homme/Femmes, l’âge median était 77 ans et 85 ans et la survie à 2 ans 50,3% et 84,9%. Les fractures intertrochantériennes comminutives (n=204) avaient le plus de complications (25%): perforations céphaliques (9,7%), problèmes de matériel (3,5%), difficultés de cicatrisation de paroi (11,8%); respectivement H/F, l’âge median était 75 ans et 85 ans et la survie à 2 ans 92,7% et 66,5%. Les fractures sous trochantériennes (n=64) avaient 17% de complications :aucune perforation céphalique mais 9,1% d’autres problèmes liés au matériel et 7,8% de difficultés de cicatrisation de paroi; respectivement H/F, l’âge moyen était 72 ans et 83 ans et la survie 92,3% et 67,9%. Les femmes avaient un taux de complications plus élevé que les hommes (19% versus 10%). Les trois types de fractures montraient des caractéristiques différentes en termes d’âge, de sexe, de complications et de taux de survie.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, University Hospital, Hoppe- Seyler-Str. 3, 72076, Tübingen, Germany

    Andreas A. Suckel & Nikolaus Wuelker

  2. Department of Medical Biometry, Eberhard-Karls University, Westbahnhofstr. 55, 72070, Tübingen, Germany

    Klaus Dietz

  3. Department of Trauma and Orthopedic Surgery, University Hospital, Hugstetter Str. 55, 79106, Freiburg, Germany

    Peter Helwig

Authors
  1. Andreas A. Suckel
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  2. Klaus Dietz
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  3. Nikolaus Wuelker
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  4. Peter Helwig
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Correspondence to Andreas A. Suckel.

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Suckel, A.A., Dietz, K., Wuelker, N. et al. Evaluation of complications of three different types of proximal extra-articular femur fractures. International Orthopaedics (SICO 31, 689–695 (2007). https://doi.org/10.1007/s00264-006-0250-4

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  • DOI: https://doi.org/10.1007/s00264-006-0250-4

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