Comparison of Outcomes of Intertrochanteric Fracture Fixation Using Percutaneous Compression Plate Between Stable and Unstable Fractures in the Elderly

OBJECTIVES:To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures. DESIGN:Clinical prospective nonrandomized cohort study. SETTING:San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital. PATIENTS:Patients older than 65 years undergoing surgery for an intertrochanteric hip fracture (n = 657) were divided according to the OTA/AO classification, into stable (31-A1) (group A, n = 363) and unstable fractures (31-A2) (group B, n = 294). INTERVENTION:Osteosynthesis with a PCCP (Orthofix Inc). MAIN OUTCOME MEASUREMENTS:Blood loss, wound complications, postoperative pain, operative and fluoroscopy time, functional outcomes, device-related complications, consolidation time, and mortality. RESULTS:Patients with unstable fractures were significantly worse with respect to postoperative pain, immediately (P = 0.020), at 6 weeks (P = 0.0001), and at 3 months (P = 0.009), and with respect to independent walking ability at 6 weeks. No other significant differences were observed. CONCLUSIONS:The outcomes of osteosynthesis with PCCP seem to be equally satisfactory in stable and unstable intertrochanteric fractures, with stable fractures having less pain and a greater ability to walk earlier. LEVEL OF EVIDENCE:Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.