Abstract

Different studies on the treatment of 756 intertrochanteric fractures type Ie-ID of Evans and Jensen and type A2 according to Muller allow us to conclude that: <br />- There is no difference as to mortality rate after 1 year in patients treated with internal fixation (DHS) or patients treated with an endoprosthesis (EP) (23 versus 24%) (p> 0.05). <br />- The tinal functional evaluation after one year shows that the results of DHS fixation and EP surgery are quite comparable (65% good results) and are better than in patients treated with blade plates or Ender nails (p < 0.01). <br />- The transfusion requirement is higher after EP treatment than after DHS treatment (p < 0.05). <br />- The DHS as well as the EP treatment rarely lead to major complications requiring reoperation (3%versus 1%) (p > 0.05). <br />- The highest complication rate after DHS-treatment (severe collapse) (80%) is observed in patients with Evans and Jensen ID or Muller A2-2/3 fractures enjoying a normal functional status pre-injury. These fractures may be the only indication for primary EP replacement.