Intertrochanteric versus femoral neck hip fractures: Differential characteristics, treatment, and sequelae

Background. More than 220,000 persons 65 years and older fracture a hip eve ry year in the United States. Although hip fractures have been considered a s a single, homogeneous condition, there are two major anatomic types of pr oximal femoral fractures: intertrochanteric and femoral neck. The present s tudy's objective was to determine if the two types of hip Fracture have dif ferent patient characteristics and sequelae. Methods. A prospective study of 923 elderly patients admitted to seven Balt imore hospitals for a hip fracture between 1984 and 1986. Results. Patients with intertrochanteric fractures were slightly older, sic ker on hospital admission, had longer hospital stays, and were less likely at 2 months postfracture to have recovered activities of daily living than femoral neck fracture patients. Intertrochanteric fracture patients also ha d higher mortality rates at 2 and 6 months after fracturing. Long-term reco very (1 year) did not differ between fracture type. Conclusions. It appears that intertrochanteric Fracture patients have intri nsic factors (older age, poor health) impacting upon their risk of Fracture and ability to recover. Differences in patient characteristics and sequela e do exist between femoral neck and intertrochanteric hip fracture patients that impact upon recovery.