[Surgical approaches for intertrochanteric fractures in elder patients].

Objective: To conduct long-term follow-ups on the efficacies of surgical approaches for intertrochanteric fractures in elder patients.

Methods: The outcomes of intertrochanteric fractures in 402 elder patients undergoing different surgical procedures during 2005 to 2009 were reviewed. The modified classification of Singh index, detailed surgical contraindications and improved functional scoring system specialized for intertrochanteric fracture were included. Among these, type I to IV had 17 cases (4%), 49 cases (12%), 187 cases (72%), 48 cases (12%). The follow-up period was 1 - 5 years. The orthopedic complications, rehabilitation duration and functional scores were reviewed.

Results: Most patients achieved self-care at 1 month post-operation. The failure rate of internal fixation was 5% and infection rate 1.9% in hemiarthroplasty. type I to IV had 70.6% and 100.0%, 85.7% and 86.7%, 85.4% and 92.0%, 72.9% and 87.5% cases showed excellent or good outcomes at 3 month and 1 year. During a follow-up period of 5 years, there was no occurrence of prothetic loosening or excessive wear of acetabular.

Conclusion: A rational selection of surgical approaches may markedly reduce the failure rate of internal post-operative fixation and shorten the rehabilitation period. And the long-term follow-up outcomes are satisfactory.