Background: intertrochanteric fractures, commonly caused by falls in older people, are a significant issue. This study evaluated a new fixation technique for greater trochanter fractures in elderly hip arthroplasty patients. Unstable intertrochanteric fractures present challenges in orthopedic surgery, and this article assessed a new method for fixing these fractures during hip arthroplasty. Objectives: We assessed the efficacy and clinical outcomes of a new fixation technique for managing greater trochanter fractures in elderly patients during hip arthroplasty. Methods: This retrospective study, conducted from 2019 to 2022 at Poorsina and Pars hospitals in Rasht, included patients with Unstable intertrochanteric fractures. It assessed the efficacy and outcomes of a new fixation technique for the greater trochanter following hip arthroplasty. Statistical analyses were conducted using SPSS software, version 24, employing the Shapiro-Wilk test, Levene’s test, generalized estimation equations, and the chi-square and Fisher’s exact tests. Results: The new fixation technique significantly improved patient outcomes, leading to high rates of complete union, reduced pain levels, improved mobility, and lower complication rates. Conclusion: The novel fixation technique for greater trochanter fractures shows significant promise in improving healing rates and reducing complications in elderly patients undergoing hip arthroplasty. This study provides a foundation for future research and clinical practice enhancements in orthopedic surgery.

Background: The best method for repairing intertrochanteric fractures is still controversial. The fixation methods include extramedullary (EM) and intramedullary (IM). Studies that compare IM and EM fixations for Unstable hip fractures are rare. In this study, our goal was to compare the efficacy of EM and IM fixation in treatment of Unstable intertrochanteric fractures. Methods: A total of 113 patients with Unstable intertrochanteric were randomized in this cohort study between March 2016 and June 2018 in trauma center of Kashani and Alzahra Hospitals, Isfahan, Iran. The patients were followed for a period of 12 months with sequential clinical and imaging evaluations. Baseline data were recorded at the time of injury. Radiographs were evaluated immediately post-operatively and at the scheduled follow-up intervals. Results: A total of 20 of patients were excluded during the study and finally 93 patients (43 males and 50 females) with mean age of 62. 74± 16. 4 completed the follow-up sessions. Mann-Whitney test indicated a significant difference in tip-apex distance between the two groups. While the two groups were homogeneous in the baseline LEM score, it was not significantly different between two groups after 1 and 3 months of surgery as well. However, the LEM score was significantly higher in IM group after 6 and 12 months of surgery. Conclusion: According to our findings, IM nails (such as the cephalomedullary nail) afforded more advantages over EM devices (such as the DHS and DCS) in the treatment of Unstable intertrochanteric fractures. Our results indicated that the final LEM scores as well as the time to union were better in IM fixation group.

Background and purpose: Intertrocentric femoral fracture is the most common fracture and has the highest mortality rate after surgery. The main treatment for this type of fracture is surgery and the choice of appropriate surgical instrument plays a key role in reducing the incidence of complications. This study amed at comparing clinical outcomes between Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) in surgical treatment of Unstable intertrochanteric fractures of the femur. Materials and methods: A cross-sectional study using causal-comparative design was conducted in all patients attending orthopedic clinic in Sari Imam Khomeini Hospital with intermittent femoral fractures who needed surgical treatment between 2012 and 2018. Thirty patients were randomly divided into two groups to be treated either by DHS or PFN implants. The two groups were compared for clinical results, including operation time and and anesthesia time, the need for blood transfusion during and after the surgery, cut out of the device, fracture fusion, and neck and emoral trunk angles. Data analysis was done in SPSS V21. Results: Findings showed no significant difference between DHS and PFN implantation in terms of fracture fusion (P= 0. 234) and cut-out of the device after the surgery (P= 0. 157). It was also found that DHS required less time for surgery and anesthesia (P= 0. 012). Patients treated with DHS also required significantly less blood transfusion than those in PFN group (P= 0. 02). Conclusion: In this study, treatment of Unstable intertrochanteric fractures using DHS was found to be superior to PFN due to lower length of surgery and anesthesia, and lower need for blood transfusion.

Background: This study aims to investigate early and delayed mortality rates and hospitalization duration among patients with delayed and early femoral intertrochanteric fractures.  Objectives: To compare short and long-term mortality rates and hospitalization duration between intertrochanteric fracture patients receiving early and delayed surgical treatment. Methods: In this cross-sectional study demographic data, underlying disease history, pre-surgery hospitalization duration, surgery duration, and post-surgery hospitalization duration were extracted from patient files. Patients were divided into two groups with and without delay in surgery. Patients’ mortality rates were divided according to the time elapsed after the operation. They were divided into short-term and long-term categories. Data were analyzed using SPSS software, version 26. Results: No significant difference was observed between the two groups in terms of age and sex distribution, but the frequency of underlying disease was significantly higher in the delayed surgery group (P<0.001). Also, mean hospital stay duration (P<0.001), surgery duration (P<0.001), short-term mortality (P=0.01) and long-term death (P<0.001) were significantly higher in the delayed surgery group. Conclusion: Delayed surgery correlates with increased early and late mortality rates and prolonged hospital stay among patients with intertrochanteric femoral fractures.