Influence Of Preoperative Systemic Complications On The Clinical Outcome Of Intertrochanteric Fracture In Elderly Patients

Objective:To investigate the influence of preoperative systemic complications on the clinical outcome of intertrochanteric fracture treated with proximal femoral nail antirotation(PFNA) in elderly patients.Methods:A retrospective analysis was performed of 93 elderly patients with intertrochanteric fracture who had been treated in the People’s Hospital of Shaoxing from January 2014 to June 2015. They were divided into 2 groups according to presence or absence of preoperative systemic complications. In the complication group, there were 49 patients,27males and 22 females, with an average age of (77.6±4.7); there were 5 cases of type Ⅰ A,7 cases of type I B,10 cases of type II A,15 cases of type ⅡB and 12 cases of type Ⅲ by the modified Evans classification. In the complication-free group, there were 44 patients,14 males and 23 females, with an average age of (77.8±4.0); there were 4 cases of type I A,5 cases of type I B,10 cases of type II A, 12 cases of type ⅡB and 13 cases of type Ⅲ by the modified Evans classification. The perioperative blood loss and the hip function by Harris scoring and complications at the last follow-up were compared between the 2 groups.Results:The perioperative blood loss in the complication group (211.6±34.2mL) was higher than in the complication-free group (165.3±29.4mL) (P<0.05). By Harris scoring, the hip function scores was (80.5±6.9) in the complication group while the hip function scores was (90.5±5.0) in the complication-free group. The scores in the former was significantly lower than that in the latter(P<0.05). The rate of postoperative complication was 14.3%(7/49) in the complication group, significantly higher than that 2.2%(1/44) in the complication-free group (P<0.05).Conclusion:Preoperative systemic complications are important factors affecting the clinical outcome of PFNA fixation for intertrochanteric fractures in elderly patients.