Zora Hakan, Bayrak Gökhan, Bilgen Ömer Faruk
Department of Orthopedics and Traumatology, Private Medicabil Hospital, 16140 Nilüfer, Bursa, Türkiye.
Department of the Physiotherapy and Rehabilitation, Faculty of Health Sciences, Muş Alparslan University, 49250 Merkez, Muş, Türkiye.
Medicina (Kaunas). 2025 Mar 27;61(4):605. doi: 10.3390/medicina61040605.
: Intertrochanteric fractures of the femur are common in the elderly due to the increase in longer life expectancy. However, unstable intertrochanteric fractures in the elderly population were still a significant concern for the postsurgical period after total hip arthroplasty (THA). This study aimed to compare the demographics, operative time, dislocation rate, and length of stay of the novel interfragmentary technique (IFT) and the conventional posterolateral approach (CPA) for unstable intertrochanteric femoral fractures treated with THA in the elderly. : This retrospective study investigated community-dwelling elderly patients with type III, IV, and V unstable femoral intertrochanteric fractures according to the Evans-Jensen classification, treated with THA by a well-experienced single surgeon. The patients were separated into IFT (n = 74) and CPA (n = 67) groups. Patient demographics (age, gender, and body mass index), total surgical duration, dislocation rates, length of stay and follow-up, and complication rates were recorded. : The mean age was 80.37 years in the IFT and 80.14 in the CPA groups ( = 0.838). Body mass index, gender, complication, and revision rates did not differ between groups ( > 0.05). The mean follow-up of the IFT group was 4.15 years, and 10.25 years in the CPA group ( = 0.001). Total surgical duration was comparable, with 69.98 min in the IFT group and 69.55 min in the CPA group ( = 0.697). The dislocation rate was 2.7% (n = 2) in the IFT group and 9% (n = 6) in the CPA group ( = 0.109). The mean length of stay was 66.97 h in the IFT group and 67.83 h in the CPA group ( = 0.729). The interfragmentary surgical technique, a novel technique for unstable intertrochanteric fracture surgery, shows promising clinical outcomes. Preserving the short rotator muscles and posterior capsule utilizing the novel IFT can be advantageous for the risk of dislocation without increasing surgical duration. It can be concluded that performing THA using IFT emerges as a practical and viable procedure for treating unstable intertrochanteric fractures in elderly patients.
由于预期寿命的增加，股骨转子间骨折在老年人中很常见。然而，老年人群中的不稳定转子间骨折仍是全髋关节置换术（THA）术后的一个重要问题。本研究旨在比较新型骨折块间技术（IFT）和传统后外侧入路（CPA）在老年不稳定转子间股骨骨折THA治疗中的人口统计学特征、手术时间、脱位率和住院时间。
这项回顾性研究调查了根据Evans-Jensen分类为III型、IV型和V型不稳定股骨转子间骨折的社区居住老年患者，由一位经验丰富的单一外科医生进行THA治疗。患者被分为IFT组（n = 74）和CPA组（n = 67）。记录患者的人口统计学特征（年龄、性别和体重指数）、总手术时间、脱位率、住院时间和随访情况以及并发症发生率。
IFT组的平均年龄为80.37岁，CPA组为80.14岁（P = 0.838）。两组之间的体重指数、性别、并发症和翻修率没有差异（P > 0.05）。IFT组的平均随访时间为4.15年，CPA组为10.25年（P = 0.001）。总手术时间相当，IFT组为69.98分钟，CPA组为69.55分钟（P = 0.697）。IFT组的脱位率为2.7%（n = 2），CPA组为9%（n = 6）（P = 0.109）。IFT组的平均住院时间为66.97小时，CPA组为67.83小时（P = 0.729）。骨折块间手术技术是一种用于不稳定转子间骨折手术的新技术，显示出良好的临床效果。利用新型IFT保留短旋转肌和后关节囊对脱位风险可能有利，且不增加手术时间。可以得出结论，使用IFT进行THA是治疗老年患者不稳定转子间骨折的一种实用且可行的方法。
