Ghulam H Saadat1*, Faizan Mazhar2 and Faran Bokhari1
1Department of Trauma and Burn Surgery, Cook County Health, USA
2Department of Biomedical and Clinical Sciences L. Sacco, Unit of Clinical Pharmacology, "Luigi Sacco" University Hospital, University of Milan, Italy
Background: Trochanteric fractures are common among geriatric population. Patient outcomes (i.e. early weight bearing, and length of hospital stay) depend on treatment modalities. While there’s a growing preference to treat these types of fractures with intramedullary implant, less evidence is available on its immediate outcomes. The present study compared the short-term outcomes of the intramedullary implant and extramedullary implant in the treatment of trochanteric fractures. The primary outcome of this study was weight-bearing on day one. The secondary outcomes were duration of post-operative Deep Vein Thrombosis (DVT) prophylaxis and Length of Stay (LOS). Method: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for patients with isolated trochanteric fractures admitted between 2016 to 2017. Patients with preoperative use of mobility aid were excluded from the study. Patients presented with sepsis were also excluded. Results: 3322 patients met the inclusion criteria. Treatment with the intramedullary implant was associated with a slightly higher rate of weight-bearing on day one [ARR: 1.051 (95% CI: 1.007-1.02); p=0.021], low incidence of post-operative DVT prophylaxis up to 28 days [ARR: 0.896 (0.85-0.94); p=0.0001] and shorter mean LOS [0.83 days (1.480-0.183); p=0.012] compared with extramedullary implant. Conclusion: This study supports the use of intramedullary implant in the treatment of trochanteric fractures as it is associated with early weight-bearing, less need for post-operative DVT prophylaxis and shorter length of stay.
Hip fracture; Intramedullary implant; Extramedullary implant; Early weight-bearing
Saadat GH, Mazhar F, Bokhari F. Intramedullary Implant is Associated with Early Weight Bearing in Trochanteric Fractures: An ACS-NSQIP Analysis. Clin Surg. 2021; 6: 3290..