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Geriatric Intertrochanteric Fractures: What Is the Optimal Follow-Up Period?
John Green1, John Tracy Watson, Philip Shaheen
1Department of Orthopaedic Surgery, Saint Louis University School of Medicine, Saint Louis, MI.
Objective:
Evaluate patients with intertrochanteric fractures who were treated operatively to determine optimal follow-up to ensure complete fracture healing and recognize complications.
Design:
Retrospective review.
Setting:
Academic Level 1 trauma center.
Patients/Participants:
Inclusion criteria included isolated intertroch fractures (not pathologic) and complete radiographic and clinical data, with at least 1-year follow-up. Four hundred ninety-seven patients were identified. Two hundred forty-nine patients met inclusion criteria with 194 patients studied.
Intervention:
Operative fixation with either CMN or SHS.
Main Outcome Measurements:
Radiographic parameters included time to union, neck-shaft angle, tip apex distance, and femoral neck screw telescoping (shortening) for both CMS and SHS combined. Postoperative complications were recorded.
Results:
Union was achieved at a mean of 64.8 ± 30.7 days. Mortality (n = 12), infection (n = 4), and implant failure (n = 5) occurred within 3 months. Neck-shaft angle was changed before 3 months. Significant neck shortening for both CMN and SHS occurred within 6 weeks ( P =<0.001). Major complications occurred early, within 3 months.
Conclusions:
Most fractures healed by 3 months and the remainder by 6 months. Routine follow-up for 6 months is more than sufficient for most of these fractures.
Level Of Evidence:
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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