Management of Intertrochanteric Fractures: An International Comparison

Abstract

Introduction

Annually there are more than 250,000 hip fractures in the United States, most of which are associated with significant issues or morbidity and mortality. Of these, approximately half are intertrochanteric fractures of the hip. Intertrochanteric fractures are particularly burdensome as they frequently result in significant blood loss, high rates of post-operative complications, and approximately a 33% 1-year mortality in addition to high rates of patient morbidity. While it is understood that intertrochanteric fractures are to be treated surgically unless otherwise contraindicated, the approach to surgery and perioperative care varies greatly throughout the world.

Methods

Charts of 13 patients that underwent ORIF of intertrochanteric fractures, May 2023 to June 2024 at Mavromati Hospital in Botoşani, Romania were analyzed and compared to the average demographic data in the United States. Analysis comparing surgical techniques, post-operative management, and short-term outcomes of patients between Botoşani, Romania and the United States were observed and reported.

Results

Patient demographics and surgical approaches are similar between surgical site in Botoşani, Romania and the United States, but differing perioperative practices including intraoperative anesthesia, post-operative analgesia, and post-operative follow up may contribute to differences in outcomes between the two nations.

Conclusions

Healthcare shortcomings that take place in the United States are analogous to those faced at Mavromati Hospital in Botoşani, Romania. Collaborating to address issues such as poor surgical outcomes in settings which vary in terms of resources and culture will benefit individuals on both sides of the collaboration to provide more holistic and effective care to patients.