Intertrochanteric hip fractures in octogenarian patients: Do we need to rethink fixation strategy?

OBJECTIVE To compare outcomes in octogenarians with younger patients up to 1 year after undergoing dynamic hip screw fixation for intertrochanteric fractures to see the effectiveness of the implant. METHODS The retrospective case-control study was conducted at The Aga Khan University and comprised records of patients who underwent dynamic hip screw surgery between January 1, 2010, and December 31, 2012. They were divided into two groups based on their age:. Group A <80 years; and Group B > 80 years. All patients had a one-year follow-up> Data including mortality, morbidity, radiological healing time, postoperative ambulatory status and Harris hip score were recorded. RESULTS Of the 150 patients, 114(76%) were in Group A and 36(24%) were in Group B. Up to 25(70%) of octagenarians dropped their ambulatory ability by one or two levels, whereas 107(94%) of Group A patients were able to either maintain their pre-injury ambulatory ability or dropped their ambulation by one level only (p=0.02). Postoperative complications were higher in Group B 9(25%) compared to Group A 4(4%). One-year mortality was also significantly higher in Group B 8(22%) compared to Group A 9(8%) (p=0.03). CONCLUSIONS Octagenarians undergoing internal fixation with dynamic hip screw had higher frequency of complications and death compared to younger patients.