Factors affect stability of intertrochanteric fractures when elderly patients fall

BACKGROUND: Factors affecting the stability of intertrochanteric fractures when elderly patients fall are few to be reported. In this retrospective study, possible factors were investigated. METHODS: Two hundred and twenty-three consecutive elderly patients (≥65 years) with intertrochanteric fractures due to low energy injuries were studied. Patient age, gender, body mass index (BMI), body weight and height were compared between fractures with stable (AO/OTA type A(1,) intact lesser trochanter, 80 patients) and unstable (AO/OTA types A(2), A(3,) displaced lesser trochanter or reverse obliquity fractures, 143 patients) types. Statistical approaches with univariate and multivariate analyses were performed. RESULTS: There was no statistical difference in patient gender, age, body weight or height between patients with stable and unstable fractures in both univariate and multivariate analysis. However, BMI was statistically higher in patients with unstable fractures (22.7 vs 21.4, p = 0.01) in univariate analysis, but without a difference in multivariate analysis (p = 0.07). CONCLUSIONS: Stability of intertrochanteric fractures may be not associated with gender, age, body weight and height or BMI when elderly patients fall. Bone mineral density or impact direction may be other possible contributing factors but requires further proofs.