Combined irreducible femoral head fracture-dislocation (Pipkin Ⅳ) and ipsilateral irreducible intertrochanteric fracture: A case report.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors have no conflicts of interests to disclose. 20. Front Surg. 2025 Jan 7;11:1510094. doi: 10.3389/fsurg.2024.1510094. eCollection 2024. Surgical options for Evans-Jensen type IV intertrochanteric femur fractures in the elderly over 65: a comparison between total hip arthroplasty and proximal femoral nail antirotation. Sun M(#)(1), Liang HR(#)(1), Zhang H(#)(2), Bai T(3), Xu RD(1), Duan SY(1), Cai ZC(1)(4). Author information: (1)Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China. (2)Sports Medicine, Tongliao People's Hospital, Tongliao, Inner Mongolia, China. (3)Department of Orthopedics Surgery, Shenyang Ninth People's Hospital, Shenyang, Liaoning, China. (4)Liaoning Province Key Laboratory for Phenomics of Human Ethnic Specificity and Critical Illness, and Shenyang Key Laboratory for Phenomics, Shenyang, Liaoning, China. (#)Contributed equally BACKGROUND: Currently, there is no clear standard for the surgical options for Evans-Jensen Type IV intertrochanteric femur fractures in elderly patients over 65 years old. This study aims to retrospectively analyze and compare the early postoperative limb function and quality of life of patients treated with total hip arthroplasty (THA) and proximal femoral nail antirotation (PFNA) for this type of fracture. We hypothesize that there is no significant difference in complications and postoperative recovery between the two surgical methods. METHODS: A retrospective analysis was conducted on patients over 65 years old with Evans-Jensen Type IV intertrochanteric femur fractures who were treated between 2020 and 2023. The patients were divided into two groups based on the treatment method: the PFNA group (20 cases) and the THA group (20 cases). General patient information, operative time, intraoperative blood loss, time to postoperative mobilization, time to weight-bearing on the affected limb, Harris hip scores at 1, 3, and 6 months postoperatively, excellent and good rates, SF-36 scores, and postoperative complications were recorded. RESULTS: Compared to the PFNA group, the THA group had a longer operative time (86.7 ± 9.6 vs. 51.5 ± 5.3 min, p