August 1, 1989

Operative or conservative treatment for trochanteric fractures of the femur. A randomised epidemiological trial in elderly patients

Structured PICO

Does operative treatment by AO dynamic hip-screw improve outcomes compared to traction in elderly patients with extracapsular hip fractures?

Population

Elderly patients with extracapsular hip fractures

Intervention

Operative treatment by AO dynamic hip-screw

Comparator

Conservative treatment by traction

Outcome

Six-month mortality, complications, pain, leg swelling, unhealed sores, anatomical results, hospital stay, and loss of independence

Operative treatment with a dynamic hip-screw for elderly patients with extracapsular hip fractures reduces hospital stay and preserves independence better than conservative traction.

Abstract

All elderly patients with extracapsular hip fractures seen in hospitals in Newcastle upon Tyne over a 12-month period were studied and followed up for six months. At one of the hospitals, patients were randomised to treatment by AO dynamic hip-screw or by traction. Complications specific to the two treatments were low, and general complications, six-month mortality and prevalence of pain, leg swelling and unhealed sores, showed no difference between the two modes of treatment. Operative treatment gave better anatomical results and a shorter hospital stay, but significantly more of the patients treated by traction showed loss of independence six months after injury.

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