A Clinical Study on Mobility Outcomes After Surgical Fixation of Intertrochanteric and Shaft Femur Fractures

Femoral fractures are a major orthopedic burden with comprehensive implications on both the mobility and health care resources of the patient. Early rate of recovery and functional locomotion is the most significant in its ability to reduce hospitalization and maximize postoperative quality of life after surgical repair. This study was performed to compare early postoperative mobility, complications, and length of stays of intertrochanteric and femur shaft fracture patients undergoing surgery.

The prospective study consisted of 90 adults with isolated intertrochanteric or shaft femur fractures in a tertiary orthopedic unit over 18 months. The patients were assigned into two groups determined by the type of fracture: intertrochanteric fractures (n = 45) were undergoing treatment with dynamic hip screws, and shaft femur (n = 45) with intramedullary nailing. The PROMIS Physical Function (PROMIS-PF) short form and Timed Up-and-Go (TUG) tests were used to evaluate mobility after three and six months of the surgery. Hospital stays and complications were also noted. The statistical analysis was conducted by SPSS (IBM Corp., Armonk, NY, USA) using chi-square, independent t-tests, and the Pearson correlation method. Statistical significance at p < 0.05 was considered significant.

Ninety patients were taken (45 each group) with a mean age of 63.8 years, where the intertrochanteric group was older (66.1 vs. 61.5 years, p=0.038) but similar in sex and comorbidities. The difference in the mean PROMIS-PF 10a scores between intertrochanteric fracture and shaft fracture was significant after three and six months of follow-up (58.4 vs. 52.7, p=0.003, and 66.3 vs. 60.6, p=0.004). The TUG test results indicated quicker mobility times in the intertrochanteric group after three and six months (p=0.012 and p=0.007, respectively). The rates of complications were not different across the groups (five (11.1%) vs. six (13.3%), p=0.743), mainly postoperative wound infections, transfusion requirements, and delayed union. Intertrochanteric fracture patients spent less time in the hospital compared to shaft fracture patients; 7.2 ± 2.1 versus 9.0 ± 3.4 days (p=0.001).

Better early mobility and reduced hospitalization rates are associated with the surgical fixation of intertrochanteric femur fractures than shaft femur fractures. These findings suggest more specific rehabilitation guidelines and fracture-type-dependent counseling for patients.