Trochantric severity score a useful tool to assess outcomes after intertrochantric fractures

Abstract

INTRODUCTION: Intertrochanteric fractures (ITF) are of intense interest globally. These fractures are most frequently operated type having the highest postoperative fatality rates and hence have become a serious health resource issue. AIM: The aim of this study is to assess the risk factors and their effect on the outcome of intertrochanteric fractures treated by sliding hip screw fixation. SETTINGS AND DESIGN: This is a retrospective and prospective observational study of all the intertrochanteric fractures treated by sliding hip screw fixation at our institute between January 2013 to August 2015. MATERIALS AND METHODS: A total of 78 intertrochanteric fractures have met the inclusion criteria proposed for the study. Preoperative and intraoperative risk factors were assessed for all the cases and treated by sliding hip screw. The Radiological outcome was assessed after a minimum follow-up of 3 months for all the cases. RESULTS: When comparing all the preoperative and intraoperative variables independently with the outcome, P value was found to be statistically significant only in displacement, reverse obliquity, inadequate lateral wall thickness, and reduction. We devised a scoring system to assess the risk outcome in the treatment of trochanteric fractures based on local fracture factors. Least score of zero and a maximum score of eight was seen in the study participants. CONCLUSION: Trochantric severity score is a useful tool to assess the outcome of management of intertrochanteric fractures. Sliding hip screw may not be an ideal implant for, trochantric fractures with inadequate lateral wall thickness (failure rate of 63%), reverse oblique type of trochanter fractures (failure rates of 50%), and displaced comminuted fractures (failure rate of 13%).