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International Journal of Orthopaedics Sciences 2021; 7(1): 219-221
E-ISSN: 2395-1958
P-ISSN: 2706-6630
IJOS 2021; 7(1): 219-221
© 2021 IJOS
www.orthopaper.com
Received: 07-11-2020
Accepted: 09-12-2020
Dr. Dilip Gupta
Consultant, Department of
Orthopedics, District Hospital
Basti, Alinagar Marg, Murlijot,
Basti, Uttar Pradesh, India
Dr. Narendra Kumar Kushwaha
Associate Professor, Department
of Orthopedics, King George's
Medical University, Shah Mina
Rd, Chowk, Lucknow,
Uttar Pradesh, India
Dr. Vijay Gupta
Consultant, Department of
Orthopedics, Siddhartha Ortho &
Neuro Care Center Railway
Godam Road Chapadiya,
Coloney, Khalilabad, Sant Kabir
Nagar, Uttar Pradesh, India
Corresponding Author:
Dr. Narendra Kumar Kushwaha
Associate Professor, Department
of Orthopedics, King George's
Medical University, Shah Mina
Rd, Chowk, Lucknow,
Uttar Pradesh, India
A prospective study of the patients, commonly elderly
people of complex proximal femur fractures, in North
India tertiary teaching hospital
Dr. Dilip Gupta, Dr. Narendra Kumar Kushwaha and Dr. Vijay Gupta
DOI: https://doi.org/10.22271/ortho.2021.v7.i1d.2483
Abstract
Background: The incidence of this type of fracture with age, due mainly to the increase in the number of
falls associated to a larger osteoporosis prevalence. It is more commonly related with senior females,
resident in the urban areas and institutionalized. Femur fractures are devastating injuries that most
commonly affect the elders and young population also. In young and healthy individuals, the injury
results from high energy trauma, whereas in the elder age group, most of the fractures are osteoporotic,
resulting from a trivial fall.
Aim: To study of the patients, commonly elderly people of complex proximal femur fractures.
Material and Methods: In our study, we have studied 20 cases of adult patients with complex proximal
femur fractures with communition and osteoporosis. Clinical and demographic characteristic were
studied such as mode of injury, side affected and associated injuries too.
Results: In our result section majority of the patients were in the age group of 41-60 years and 61-80
years i.e., 8 patients each (40% each). Most of the patients were male i.e., 12 (60%) and 8 (40%) were
female. The most common mode of injury was road traffic accidents in 10 patients (50%) followed by
fall from height in 7 (35%) patients. Both right and left side were equally affected.
Conclusion: Here we can conclude that as per recent studies so as in our study too complex proximal
femur fractures were more common in old age and in females which could be attributed by underlying
osteoporosis prevalent more in females. The intra-hospital mortality, until the end of one month, three
months, six months, one year and two years. Other decisive factors in the mortality, such as walking
ability capacity previous to the fracture, ASA index, anemia, hypalbuminemia, lymphopenia and the
existence of CVA were found in some isolated studies.
Keywords: femur fractures, complex proximal femur fractures, old age, trivial fall, road traffic accidents
Introduction
Femur fractures are devastating injuries that most commonly affect the elders and young
population also. With the increase of the life expectancy and consequently with the largest
proportion of seniors in the population, mainly the so-called "big" seniors (those with more
than 80 years), the importance of this type of fracture has been increasing in the last years
[1]
.
In England and Wales, in the biennium 1997/1998, sixty six thousand seniors were
hospitalized with a fracture of the femur, while in the United States it was considered that
350.000 fractures of the femur occurred annually, with a total cost of approximately 6 billion
dollars a year, in medical care only. In young and healthy individuals, the injury results from
high energy trauma, whereas in the elder age group, most of the fractures are osteoporotic,
resulting from a trivial fall. These fractures have a tremendous impact on both the health care
system and society in general. Proximal femur fractures comprise, fractures of
intertrochanteric and subtrochanteric region. Subtrochanteric fractures are complicated by
delayed or non-union
[2]
. The factors responsible for these complications in subtrochanteric
fractures are high stress concentration, predominance of cortical bone and difficulties in
getting biomechanically sound reduction because of comminution and intense concentration of
deforming forces. In inter-trochanteric fractures, which usually occur in the elderly,
stabilization of the fracture and restoring the patient to his or her preinjury functional activity
at the earliest possible time is essential to prevent complications of recumbency
[3]
.