Profile of trochanteric fractures at MOI: treatment and short-term outcome 2012.

Abstract

Trochanteric fractures are one of the hip fractures, common in old age. However, they are not uncommon in younger age group. They commonly occurs in elderly following low energy trauma. In young people, these fractures result from high energy trauma. Despite different treatment modalities of these fractures, complications do occur. Study Objective This study aimed to determine the causes of injury, treatment modalities used and short-term outcome of trochanteric fractures at Muhimbili Orthopaedic Institutes (MOI) from January 2012- Decamber2012 Methods A cohort study was done on adult patients with trochanteric fractures admitted and treated at Muhimbili Orthopaedic Institute (MOI). Ninety one patients met the study inclusion criteria, four were lost follow-up, hence 87 patients were reviewed and completed the 16 weeks of follow ups. The structured questionnaire was used to interview the participants. These patients were treated either surgically or non surgical. Those who were surgically treated, immediate post-operative radiographs were taken, length of the lower limb and coxa vara deformity were assessed. Patients who were treated non surgically were put on skin traction for four weeks, then control radiographs were taken, lower limb length and coxa vara deformity were again assessed. There after each patient was followed up for a period of 16 weeks post treatment. In the follow-up visits, state of the wound, limb length discrepancy, coxa vara deformity and function of the hip joint were assessed. The obtained data were then analyzed by using SPSS version 16.0

Results In this study 49% of cases occurred after simple fall, 43.7% of cases occurred after Road Traffic Crash (RTC). Average age of occurrence was 62.26 ± 19.19 years with male to female ratio of 2:1. Most cases were Evan’s type II classification. 60 patients were surgically treated and 27 patients were treated conservatively. Of the participants, 37.9% had coxa vara, 40.2% had limb shortening, 85.1% had score of above 20 by Salvati - Wilson hip score

Conclusion Trochanteric fractures occur due to simple fall and road traffic crash. Most of these fractures, have better outcome when surgically treated.