Perioperative morbidity and 30-day mortality after intertrochanteric hip fractures treated by internal fixation or arthroplasty.

The conventional treatment for intertrochanteric hip fracture is open reduction and internal fixation. However, hip arthroplasty is occasionally performed. The objective of this study was to determine the 30-day mortality for patients with intertrochanteric hip fracture treated with open reduction, internal fixation, or hip arthroplasty. The mortality rate for patients treated with arthroplasty at 4.8% (23/478) was slightly, but not significantly, higher than that for patients treated with open reduction and internal fixation at 4.5% (62/1395). However, more of the patients in the arthroplasty group exhibited serious intraoperative cardiorespiratory disturbances (62% vs 22%) and died in the hospital (77% vs 35%) when compared with the patients in the open reduction and internal fixation group. Although the incidence of 30-day mortality in these groups was not significantly different, the patients in the arthroplasty group were more likely to have a complicated intraoperative course and die in the hospital.