Clinical profiles and outcomes of different therapeutic protocols in elderly patients with trochanteric fractures: a...

To describe the clinical course and outcome profiles of elderly patients with trochanteric fractures, characterized by different baseline features, following different treatment pathways in clinical practice.

This single-center retrospective descriptive study consecutively enrolled 309 elderly patients with trochanteric fractures admitted between January 2021 and December 2023. Based on the actual treatment received, patients were categorized into three groups: Group A (home-based recuperation, n = 81), Group B (inpatient conservative treatment, n = 97), and Group C (inpatient surgical treatment, n = 131). The baseline characteristics, treatment-related metrics, complication profiles, and functional recovery and survival status at one-year post-injury were collected and descriptively analyzed.

Treatment selection closely matched patients' baseline health status. Patients in Group C were younger, had fewer comorbidities, and better baseline function; conversely, Group A patients were older, more frail, and had greater functional dependency. Group B patients' characteristics were intermediate. Complication profiles differed among the groups: Group C was predominantly associated with surgery-related complications; Group B exhibited a combination of fracture healing issues and immobilization-related medical complications; Group A was most notably characterized by impaired fracture healing. The one-year survival rate observed among patients in Group C was 95.42%, which was associated with their more favorable baseline health status. Rates of 91.75% and 83.95% were observed in Group B and Group A, respectively, reflecting the gradient in baseline frailty across groups. Functional recovery scores showed a parallel distribution.

This study delineates the distribution of outcomes following different treatment pathways in elderly intertrochanteric fracture patients with varying health statuses. It provides a crucial reference for individualized clinical decision-making and prognosis expectation management in this heterogeneous patient population.