Functional results in surgical treatment of unstable pertrochanteric fractures (AO/OTA A2) treated by TRIGEN INTERTAN and DHS methods

Abstract

Introduction/Objective Intertrochanteric fractures of the femur are one of the biggest public health problems. This paper aims to determine the functional results and features of operative treatment of unstable intertrochanteric femoral fractures.

Methods This retrospective study included 67 patients who were treated surgically for AO/OTA A2 pertrochanteric fractures at the Department of Orthopedic Surgery and Traumatology of the Kosovska Mitrovica Clinical Hospital Center and at the Academician Prof. Dr. Milorad Mitković Clinic for Orthopedic Surgery and Traumatology of the Niš University Clinical Center. There were two groups of patients regarding the fixation method used – the dynamic hip screw (DHS) group and the TRIGEN INTERTAN group.

Results Patients treated using the DHS method had a statistically confirmed longer operation time, greater intraoperative blood loss, and longer hospitalization in relation to patients treated using the TRIGEN INTERTAN method (p < 0.001). In contrast, patients from the TRIGEN INTERTAN group spent less time in the intensive care unit and had more favorable radiological findings regarding fracture healing, as well as better functional outcomes assessed by the Harris Hip Score and Barthel index, which were also statistically significant. The peak-to-peak tip–apex distance was greater in the DHS group, with a significant difference between the techniques (p = 0.019). According to the Charlson Comorbidity Index, patients who were treated using the DHS method had more pronounced comorbidities (p = 0.022).

Conclusion Surgical treatment of unstable pertrochanteric fractures using intramedullary fixation with TRIGEN INTERTAN is very safe and effective in all patients, especially in elderly patients with comorbidities.

Keywords: unstable; pertrochanteric; fractures; hip function