lntertrochanteric and Subtrochanteric Fractures of the Femur in the Negro

¹ Department of Surgery, Homer G. Phillips Hospital, St. Louis

This presentation of ninety-nine cases of trochanteric fractures of the femur in the Negro with a 6 per cent incidence of non-union indicates that this type of fracture does occur in the Negro and that it may not unite.

The age and sex incidence, high frequency of trivial injury, numerous concomitant disorders, high mortality rate of patients treated non-operatively, complications, and the long delay in hospitalization are striking.

These elderly poor-risk patients were found to tolerate anaesthesia and surgery very well. The oldest patient operated upon in this series was 101 years old. By the almost routine use of internal fixation in the old-age group, especially in debilitated poor-risk patients, we have been able to:

1 Reduce the hospital-case mortality rate from 50 per cent to less than 20 per cent.

2. Reduce the incidence of such complications as decubitus ulcers, hypostatic pneumonia, urinary disorders, thrombophlebitis, and pulmonary embolism from an incidence of 79.5 per cent in cases without operation to 35.6 per cent.

3. Increase the over-all good results from 33 per cent to 64.7 per cent.

4. Discharge these old people in a matter of days instead of months.

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