Research Article
Increased Fracture Collapse after Intertrochanteric Fractures Treated by the Dynamic Hip Screw Adversely Affects Walking Ability but Not Survival
Table 2
Differences in baseline and outcome variables in relation to increasing severity of collapse.
| | Baseline and surgical variables | | Amount of collapse | Minimal | Moderate | Severe | value | | %/mean | | %/mean | | %/mean | |
| | Age at operation | 83 | (SD = 0.75) | 82.6 | (SD = 0.85) | 86 | (SD = 0.62) | 0.042 | | Female versus males | 59.8% | 140 | 71.4% | 60 | 74.4% | 32 | 0.057 | | 31.A2 versus A1 | 40.2% | 94 | 65.5% | 55 | 67.4% | 29 | 0.000 | | Screw versus blade fixation | 54.7% | 128 | 58.3% | 49 | 46.5% | 20 | 0.461 | | Premorbid nonfunctional walker | 6.8% | 16 | 9.5% | 8 | 2.3% | 1 |
0.531 | | Premorbid assisted walker | 10.7% | 25 | 13.1% | 11 | 14.0% | 6 | | Premorbid independent walker | 81.2% | 190 | 77.4% | 65 | 83.7% | 36 | | Operation delayed more than 2 days after admission | 10.3% | 24 | 6.0% | 5 | 2.3% | 1 | 0.143 | | MMSE score | 15.9 | (SD = 7.4) | 16.1 | (SD = 7.7) | 15.9 | (SD = 7.4) | 0.984 | | Modified Barthel Index | 85.3 | (SD = 22.4) | 84.4 | (SD = 25.1) | 83.4 | (SD = 23.9) | 0.890 | | ASA score 3 or above | 62.0% | 145 | 63.1% | 53 | 58.1% | 25 | 0.862 | | Operated by trainees (<6 years of experience) | 31.6% | 74 | 29.8% | 25 | 30.2% | 13 | 0.941 | | Operative time | 41.5 mins | (SD = 16.3) | 43.6 mins | (SD = 18.6) | 47.8 mins | (SD = 21.3) | 0.084 | | Suboptimal centre-centre or centre-inferior lag screw position | 27.4% | 64 | 42.9% | 36 | 39.5% | 17 | 0.019 | | Suboptimal tip-apex distance > 25 mm | 0.0% | 0 | 6.0% | 5 | 0.0% | 0 | 0.002 | | Poor reduction (>4 mm translation and 5 degrees varus) | 0.9% | 2 | 7.1% | 6 | 18.6% | 8 | 0.000 | | Acceptable reduction (>4 mm translation or 5 degrees varus) | 19.7% | 46 | 42.9% | 36 | 30.2% | 13 | | Good reduction (<4 mm translation and <5 degrees varus) | 79.5% | 186 | 50.0% | 42 | 51.2% | 22 | | Perfect reduction (<2 mm translation and no varus) | 59.4% | 139 | 35.7% | 30 | 30.2% | 13 | 0.000 |
| | Outcomes |
| | Walking function | | Nonfunctional walker | 20.5% | 48 | 25.0% | 21 | 34.9% | 15 | 0.016 | | Assisted walker | 26.9% | 63 | 22.6% | 19 | 34.9% | 15 | | Independent walker | 52.6% | 123 | 52.4% | 44 | 27.9% | 12 | | Unable to maintain walking function | 34.2% | 80 | 33.3% | 28 | 62.8% | 27 | 0.028 |
| | Cumulative mortality | | Died at 6 months | 2.1% | 5 | 1.2% | 1 | 2.3% | 1 | 0.880 | | Died at 1 year | 8.5% | 20 | 8.3% | 7 | 2.3% | 1 | 0.377 | | Died at 2 years | 22.2% | 52 | 19.0% | 16 | 16.3% | 7 | 0.628 |
| | Complications | | Lateral wall fractures | 2.1% | 5 | 21.4% | 18 | 55.8% | 24 | 0.000 | | Any mechanical failure | 0.4% | 1 | 7.1% | 6 | 23.3% | 10 | 0.000 | | Implant migration in femoral head | 0.4% | 1 | 4.8% | 4 | 11.6% | 5 | 0.001 | | Hip joint penetration and cutout | 0.0% | 0 | 2.4% | 2 | 11.6% | 5 | 0.000 | | Side plate pullout | 0.0% | 0 | 0.0% | 0 | 2.3% | 1 | 0.111 | | Nonunion | 0.0% | 0 | 1.2% | 1 | 16.3% | 7 | 0.000 | | Infection | 0.4% | 1 | 0.0% | 0 | 4.7% | 2 | 0.053 | | Reoperations | 0.9% | 2 | 2.4% | 2 | 11.6% | 5 | 0.002 |
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Kruskal-Wallis test with Monte Carlo significance for nonparametric variables.
One-way ANOVA test for continuous variables.
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