A REVIEW ON 161 SUBTROCHANTERIC FRACTURES - RISK-FACTORS INFLUENCING OUTCOME - AGE, FRACTURE PATTERN AND FRACTURE LEVEL

The results obtained in 161 subtrochanteric fractures of the femur fol lowing treatment with a 95 degrees condylar blade plate or a dynamic c ondylar screw or a gamma nail were retrospectively analyzed. A 95 degr ees angular blade plate was used in 107 cases, a dynamic condylar scre w in 25, and a gamma nail in 29. There were 114 patients who were admi tted after a simple fall and 47 who had sustained a high-energy trauma . In the type of trauma, associated lesions, ISS, pre-existing disease s and finally age we found statistically significant difference (P < 0 .001) between patients admitted after a simple fall and patients admit ted after a high-energy trauma. The mean operating times for the 95 de grees angled blade plate, the dynamic condylar screw and the gamma nai l were 86, 85 and 74 min, respectively. Of the 161 patients, 18 requir ed a revision operation. Of these 18 patients, 8 were initially treate d using a 95 degrees condylar blade plate, 2 with a dynamic condylar s crew and finally 8 with insertion of a gamma nail; 5 of these patients were less than 70 years old, while the other 13 were older than 70 ye ars (P = 0.025; Fisher's exact test P = 0.042). The post-injury roentg enogram showed a fracture at the level of the lesser trochanter in 11 of the patients older than 50 years (P = 0.017; Fisher exact P = 0.053 ). Among the 18 patients who underwent revision operations, the post-i njury roentgenograms showed 6 type IIIA fractures and 5 type V fractur es. There was a statistically significant difference in fracture type between age groups above and below 50 years (P = 0.095; Fisher exact P = 0.043).