Evaluation of complications of three different types of proximal extra-articular femur fractures

The comparability of studies of extra-articular proximal femur fractures is compromised by the lack of a widely accepted, simple classification system with clinical and prognostic relevance. The aim of the study is to define the complication profile as well as differences relating to age, gender and survival rate of simple trochanteric fractures, intertrochanteric comminuted and subtrochanteric fractures. Records of 335 consecutive patients were analysed. Patients had a median follow-up of 10 (1–56) months, and were treated operatively with three intramedullary nailing systems. Simple trochanteric fractures (n=67) show wound healing problems (1.5%). Median age is m/f 77(45–98) years/ 85(39–101), and two-year survival rate is m/f 50.3%/ 84.9%. Intertrochanteric comminuted fractures (n=204) show the highest complications (25%), 9.7% femoralhead perforations, 3.5% hardware related problems and 11.8% wound healing problems. Median age is m/f 75(41–94) years/ 85(54–100), survival rate is m/f 92.7%/ 66.5%. Complication rate is 17.0% in subtrochanteric fractures (n=64), no femoralhead perforation but 9.1% other hardware problems and 7.8% wound healing problems. Median age is m/f 72(24–91) years/ 83(38–99), survival rate is m/f 92.3%/ 67.9%. Females show higher complication rates compared to males (19% versus 10%). The three types of fractures show different patterns of complications, survival rates, age, and sex distribution.