Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

Introduction: Intertrochanteric fractures of the femur are very common in elderly people. Their incidence has increased due to the increased life expectancy and osteoporosis; fall is the main cause of injuries.(1) Most of the classification systems for intertrochanteric fractures have poor reliability and reproducibility. Intertrochanteric fractures are considered unstable in the presence of a comminuted posteromedial cortex, reverse obliquity, and subtrochanteric extension (4). CT scan is essential for patients with 3or 4 parts unstable intertrochanteric fractures to determine the extension of the fracture to the neck and identify the actual pattern of the fracture. (42) Early operation within 12 hours to 48 hours is mandatory in the relatively fit patient.The surgical goal is to achieve a painless and stable lower limb with early return of function, with the lowest rates of mortality and morbidity.(73) Conclusion: This study concluded that the functional outcome according to HHS was superior in HA group in comparison to PFN group at 3 and 6 months and was superior in PFN group in comparison to HA group at 1 year follow up. HA group was statistically highly significant different than PFN group at 3 months but no statistically significant difference between both groups at 6 and 12 months follow up regarding HHS. Also it has concluded that PFN group take more time to return to pre fracture level of activity than HA group and that one year mortality was more in HA group with no statistically significant difference between both groups regarding one year mortality

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