Subtrochanteric Femur Fractures: The Association Between Obesity and Perioperative, Clinical, and Radiographic Outcomes.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors report no conflict of interest. 15. Clin Orthop Surg. 2024 Apr;16(2):194-200. doi: 10.4055/cios23204. Epub 2024 Feb 16. Intertrochanteric (Reverse Oblique) Fracture Subclassifications AO/OTA 31-A3 Have No Effect on Outcomes or Postoperative Complications. Factor S(1), Elbaz E(1), Kazum E(1), Pardo I(1), Morgan S(1), Ben-Tov T(1), Khoury A(1), Warschawski Y(1). Author information: (1)Division of Orthopedics, Tel Aviv Sourasky Medical Center, Affiliated to the Faculty of Medicine Tel Aviv University, Tel Aviv, Israel. BACKGROUND: Reverse oblique intertrochanteric fractures (ROFs) are unstable extracapsular hip fractures that present a mechanical challenge. These fractures are classified as AO/Orthopaedic Trauma Association (OTA) 31-A3 according to the Trauma Association classification system and can further be subclassified into 3 subtypes based on their specific characteristics. The study aimed to evaluate and compare the radiographic and clinical outcomes of the 3 subtypes of ROFs. METHODS: A retrospective study was conducted at a single high-volume, tertiary center, where data were collected from electronic medical records of consecutive patients who underwent surgical fixation of AO/OTA 31-A3 fractures. Patients with less than 1-year follow-up, pathological fractures, and revision surgery were excluded. The subtypes of fractures were classified as 31-A3.1 (simple oblique), 31-A3.2 (simple transverse), and 31-A3.3 (wedge or multi-fragmentary). The operation was done using 4 different fixation methods, and radiological evaluation was performed at routine intervals. RESULTS: The final population consisted of 265 patients (60.8% women) with a mean age of 77.4 years (range, 50-100 years) and the mean follow-up time was 35 months (range, 12-116 months). The incidence of medical complications was similar across the groups. However, there was a trend toward a higher incidence of orthopedic complications and revision rates in the 31-A3.2 group, although this was not statistically significant (p = 0.21 and p = 0.14, respectively). CONCLUSIONS: Based on the findings of this study, no significant differences were observed between the groups, indicating that the subclassifications of AO/OTA 31-A3 fractures do not have a significant impact on surgical outcomes or the occurrence of postoperative complications. Copyright © 2024 by The Korean Orthopaedic Association. DOI: 10.4055/cios23204 PMCID: PMC10973612