• Zi-Bo Yang, Pei-Hui Wu, Ping-Kwan Wong, Zhi-Yu Huang, Ming Fu, Wei-Ming Liao, Ai-Shan He, and Yan Kang.
• a Department of Orthopaedic & Joint Surgery, the First Affiliated Hospital , Sun Yat-sen University , No.58, Zhongshan 2nd Road, Guangzhou 510080 , P.R. China.
• J Invest Surg. 2018 Oct 1; 31 (5): 431-437.

PurposeTo compare the postoperative survival and mortality rates in intertrochanteric femoral fracture (IFF) patients who underwent either open reduction internal fixation (ORIF) or hip arthroplasty.MethodsClinical data from senior patients who had IFF and underwent ORIF or hip arthroplasty were analyzed retrospectively. Survival curves were compared between groups with Kaplan-Meier method and log-rank test. Significant independent prognostic factors were identified by Cox multivariate regression analysis.ResultsAll patients recovered fully post-surgery. Although 31 patients died during the follow-up period (ORIF, mean 45.4 months; arthroplasty, mean 51.6 months), mortality rate did not differ significantly between the groups. The 1-yr and 2-yr survival rate estimates for the ORIF group were 92.2%, and 86%, respectively; they were 85% and 74% for the arthroplasty group. Average survival lengths for ORIF and arthroplasty groups were 88 and 67 months, respectively. The effect of surgical approaches on survival differed significantly (log-rank test c2 = 6.402, p = 0.011). Multivariate Cox regression model indicated that surgical choice (p = 0.036) was a significant independent risk factor for the prognosis of senile IFF, even with adjustment for age (p = 0.002).ConclusionThe overall postoperative prognosis was superior in senile IFF patients treated with ORIF.

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