Geriatric Intertrochanteric Fractures: What Is the Optimal Follow-Up Period?

Abstract

Objective: Evaluate patients with intertrochanteric fractures who were treated operatively to determine optimal follow-up to ensure complete fracture healing and recognize complications. Design: Retrospective review. Setting: Academic Level 1 trauma center. Patients/Participants: Inclusion criteria included isolated intertroch fractures (not pathologic) and complete radiographic and clinical data, with at least 1-year follow-up. Four hundred ninety-seven patients were identified. Two hundred forty-nine patients met inclusion criteria with 194 patients studied. Intervention: Operative fixation with either CMN or SHS. Main Outcome Measurements: Radiographic parameters included time to union, neck-shaft angle, tip apex distance, and femoral neck screw telescoping (shortening) for both CMS and SHS combined. Postoperative complications were recorded. Results: Union was achieved at a mean of 64.8 ± 30.7 days. Mortality (n = 12), infection (n = 4), and implant failure (n = 5) occurred within 3 months. Neck-shaft angle was changed before 3 months. Significant neck shortening for both CMN and SHS occurred within 6 weeks (P=<0.001). Major complications occurred early, within 3 months. Conclusions: Most fractures healed by 3 months and the remainder by 6 months. Routine follow-up for 6 months is more than sufficient for most of these fractures. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.