[Surgical outcome in subtrochanteric fractures. A study over 15 years]

During the past 15 years new methods for the surgical approach to subtrochanteric fractures have been developed, e.g. the dynamic hip screw (DHS) and the gamma-nail (GN). Reviewing the results of this change in methods, we report on 102 patients after subtrochanteric fractures of the femur. We divided them into three groups according to the time of operation (1980-1984, period I; 1986-1989, period II; 1991-1993, period III). During period I, 74% of the fractures were stabilized using angle plates. During period III, more than 30% were operated on using the DHS and nearly 50% using the GN. The total hospital stay (department of surgery as well as geriatric hospital) decreased from 107.5 +/- 46.5 days to 78.9 +/- 24.3 days (P < 0.001). During period I, 86.2% of patients could be discharged home, during period III, 100%. Serious complications decreased during these 15 years. In conclusion, as observed in pertrochanteric fractures, the introduction of new operative techniques for the treatment of subtrochanteric fractures in the elderly was followed by a shortened hospital stay, a decreased complication rate and an increased rate of discharge home.