Outcome analysis after cephalomedullary nail implantation in older adults and elderly patients with per-, sub- or intertrochanteric femur fractures.

Objective: Per-, sub-, and intertrochanteric femur fractures are common in older adults and elderly patients. They frequently lead to functional decline and increased dependency. Despite the routine use of cephalomedullary nails (CMN) for stabilization, detailed data on perioperative outcomes in this vulnerable population are scarce.

Results: In this retrospective study, we analyzed 401 patients aged ≥ 50 years who underwent CMN fixation for per-, sub-, or intertrochanteric femur fractures at a university medical center between 2019 and 2024. Pre-, intra-, and postoperative parameters, including demographics, fracture classification, comorbidities, and functional outcomes, were extracted from hospital records and analyzed descriptively. The median patient age was 84 years (IQR 75-89) and 62.6% were female. Most fractures were classified as AO/OTA type A2 (49.9%). Prior to the fracture, 51.6% of patients were fully mobile without aids, yet only 1% maintained this mobility at discharge. The median length of stay was 12 days (IQR 7-18). In-hospital mortality was 8.4%. Postoperatively, hemoglobin and hematocrit levels declined. Discharge destinations included home (36.5%), nursing homes (19.2%), and rehabilitation facilities (12.2%).