Intertrochanteric fractures of the hip in the elderly: a retrospective analysis of 236 cases

A series of 236 patients over the age of 80 with intertrochanteric fractures were treated on a protocol established basis in an attempt to decrease postoperative morbidity and mortality. Rigid fixation with interfragmentary compression using the compression hip screw permitted us to begin early mobilization and immediate weight-bearing. Vigorous pulmonary tiolette, prophylactic antibiotics, and aspirin "anticoagulation" were used as adjuncts. Three month mortality was 7%. Overall, 76% of the patients who ambulated in any manner before their fracture walked again after surgery. Many, however, lost one grade level of walking postoperatively. Effective treatment for a patient with an intertrochanteric fracture, regardless of advanced age, is surgery and early mobilization.