EPIDEMIOLOGICAL PROFILE AND WAITING TIME FOR OSTEOSYNTHESIS OF TRANSTROCHANTERIC FRACTURES

Melo, Felipe da Silva de; Andrade, Lara Letícia Brito de; Sobreira, Gabriel Vale do Monte; Argotte, William Roberto Paredes

doi:10.1590/1413-785220253305e290192

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Original Article/Hip • Acta Ortop Bras 33 (05) • 2025 • https://doi.org/10.1590/1413-785220253305e290192 linkcopy

EPIDEMIOLOGICAL PROFILE AND WAITING TIME FOR OSTEOSYNTHESIS OF TRANSTROCHANTERIC FRACTURES

PERFIL EPIDEMIOLÓGICO E TEMPO DE ESPERA NA OSTEOSSÍNTESE DE FRATURA TRANSTROCANTERIANA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To evaluate the epidemiological profile and waiting time for osteosynthesis in patients admitted due to intertrochanteric fracture in a public hospital in the Federal District of Brazil.

Methods: This observational, descriptive, and retrospective study involved patients over 18 years old with intertrochanteric fractures between June and December 2023. Demographic, clinical data, and information about waiting time for osteosynthesis were collected. Analyses were performed using descriptive statistics and logistic regression.

Results: The majority of patients (61.4%) were female, with a mean age of 74 years. The average time between fracture and care was 3.4 days, and from fracture to osteosynthesis was 22.7 days. The mortality rate was 6.8%, with higher prevalence in elderly women with comorbidities.

Conclusions: The study demonstrates that a prolonged time between fracture and osteosynthesis is associated with worse clinical outcomes, particularly in elderly patients with comorbidities. Optimizing the waiting time for surgery is essential to reduce morbidity and mortality and improve patient recovery. Level of Evidence IV; Observational, Descriptive, and Retrospective Study.

Keywords:
Femoral Fractures; Osteosynthesis, Fracture; Indicators of Morbidity and Mortality; Treatment Delay; Aged; Rehabilitation

	Transtrocanteric				p-value
	Yes		No		p-value
Gender
Female	27	(61.4%)	19	(35.2%)	0.017
Male	17	(38.6%)	35	(64.8%)	0.017
Age group
Average	74 years		52.5 years
18 to 19 years old	0	(0.0%)	1	(1.9%)	0.003
20 to 29 years old	1	(2.3%)	8	(14.8%)
30 to 39 years old	1	(2.3%)	5	(9.3%)
40 to 49 years old	2	(4.5%)	14	(25.9%)
50 to 59 years old	6	(13.6%)	5	(9.3%)
60 to 69 years old	1	(2.3%)	9	(16.7%)
70 to 79 years old	11	(25.0%)	6	(11.1%)
80 to 89 years old	14	(31.8%)	5	(9.3%)
90 to 99 years	8	(18.2%)	1	(1.9%)
Comorbidities
Denies	13	(29.5%)	23	(42.6%)	0.172
Not available.	7	(15.9%)	8	(14.8%)
Yes	24	(54.5%)	23	(42.6%)
Circulatory System Diseases	15	(62.5%)	14	(60.9%)
Endocrine, Nutritional, and Metabolic Diseases	8	(33.3%)	8	(34.8%)
Nervous System Diseases	3	(12.5%)	5	(21.7%)
Musculoskeletal and Connective Tissue Diseases	3	(12.5%)	0	(0.0%)
Other less common comorbidities	11	(45.8%)	9	(39.1%)

	Transtrocanteric				p-value
	Yes		No		p-value
Time between the fracture occurring and my arrival.
Average	3.4 days		1.8 days
1 to 2 days	39	(88.6%)	46	(85.2%)	0.016
3 to 9 days	2	(4.5%)	5	(9.3%)
≥10 days	2	(4.5%)	1	(1.9%)
Not available.	1	(2.3%)	2	(3.7%)
Mechanism of trauma
Fall height/to the ground	36	(81.8%)	20	(37.0%)	0.007
Other less frequent mechanisms	8	(18.2%)	34	(63.0%)	0.007
Period between fracture and osteosynthesis
Average	22.7 days		25.1 days
1 to 2 days	0	(0.0%)	5	(9.3%)	0.018
3 to 9 days	6	(13.6%)	5	(9.3%)
10 to 19 years old	16	(36.4%)	17	(31.5%)
20 to 29 days	11	(25.0%)	10	(18.5%)
30 to 39 days	7	(15.9%)	5	(9.3%)
40 to 49 days	1	(2.3%)	4	(7.4%)
≥ 50 days	2	(4.5%)	6	(11.1%)
Not available.	1	(2.3%)	2	(3.7%)

	Transtrocanteric				p-value
	Yes		No		p-value
Final outcome of the patient
Satisfactory	11	(25.0%)	7	(13.0%)	0.740
Rehabilitation	18	(40.9%)	25	(46.3%)
Unsatisfactory	0	(0.0%)	4	(7.4%)
Death	3	(6.8%)	2	(3.7%)
Not available/not applicable	12	(27.3%)	16	(29.6%)
Follow-up period (in days)
Average	73.2 days		96 days
< 30 days	4	(9.1%)	5	(9.3%)	0.173
30 to 60 days	19	(43.2%)	17	(31.5%)
60 to 120 days	9	(20.5%)	11	(20.4%)
>120 days	4	(9.1%)	11	(20.4%)

	Transthoracic
	Yes	No
Time between fracture occurrence and care
Satisfactory	1.8	1.4
Rehabilitation	2.7	1.9
Unsatisfactory	-	1
Death	1	1
Period between fracture and osteosynthesis
Satisfactory	19.2	33.2
Rehabilitation	23.8	26.6
Unsatisfactory	-	18.2
Death	18	25.5
Follow-up period
Satisfactory	89	156
Rehabilitation	72	90
Unsatisfactory	-	150
Death	10	37

Period	Comorbidities
Period	Denies	One	Two	Three or More
First contact	5.7 days	1.8 days	5.5 days	1.2 days
Performing osteosynthesis	28.2 days	17.8 days	21.6 days	21.8 days
Follow-up	83 days	86 days	45 days	62 days

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