This study reviewed 66 intertrochanteric fractures in patients younger than
40 years old (average 33.0 years old; range 17-40 years old). In contrast
to the usual population with intertrochanteric fractures, the factors male
predominance (46/66), less pre-injury comorbidity (9/66), more outdoor high
energy trauma (47/66), and more associated injuries (32/66) were evident.
The distribution of associated injuries was wide. Some of them were life th
reatening. According to Boyd's classification, 20 were type I, 24 were type
II, 13 were type III, and 9 were type IV. Twenty-nine were stable, and 37
were unstable. Stratified by the mechanism of injury, the difference in dis
tribution between the subgroups was significant (p = 0.027, two-tail Fisher
's exact test). Simple falls only caused Boyd type I and II: fractures. Boy
d type III or IV fractures were found more often after vehicular trauma or
falls from a height. All the intertrochanteric fractures healed on average
70.5 days (range 31-213 days) after operation. The fractures resulting from
vehicular trauma or fall from a height healed significantly more slowly (p
= 0.02, univariant log-rank test). There were 6 intertrochanteric fracture
-related complications. The mechanism of injury determines the character of
intertrochanteric fractures in young adults. Given tougher bone stock, bet
ter healing ability, and less co-morbidity, proper management can lead to h
ealing of all intertrochanteric fractures. The extent of functional recover
y was also determined by the associated injuries.