Comparison of elderly patients with and without intertrochanteric fractures and the factors affecting fracture severity

Background: Intertrochanteric fractures in elderly patients are common and normally caused by low-energy injuries, such as falls. The favored treatment method is closed reduction with internal fixation using plate or nail systems. In general, the severity of an intertrochanteric fracture is one of key factors that affects the success rate of fixation. However, the factors that affect the severity of intertrochanteric fractures in elderly patients are rarely reported in the literature. In this prospective study, several possible factors were investigated. Methods: The bone mineral densities (BMD) of 48 elderly patients (≥ 65 years) with intertrochanteric fractures due to low-energy injuries were compared with the BMDs of 48 elderly persons without hip fractures. Both groups were composed of people of similar ages and male-to-female ratios. Furthermore, in the patients with fractures, BMD, body mass index (BMI), body weight, and body height were compared between patients with nonsevere (intact lesser trochanter; 14 patients) and severe (displaced lesser trochanter or reverse obliquity fractures; 34 patients) intertrochanteric fractures. Results: Patients with intertrochanteric fractures had significantly lower BMDs compared with persons without hip fractures to the lesser trochanter, total hip area, femoral neck, or greater trochanter (. p = 0.001, <0.001, <0.001, and <0.001, respectively). There was no statistical difference in terms of BMD, BMI, body weight, or body height between patients with nonsevere and severe fractures. Conclusion: Elderly patients with intertrochanteric fractures have lower BMDs than persons without hip fractures. However, the severity of intertrochanteric fractures cannot be predicted by local BMD, BMI, body weight, or body height.