High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for intertrochanteric fractures in elderly patients

  • Gilbert Maroun
  • Raja Chaftari
  • Jad Chokr
  • Charbel Maroun
  • Moussa El-Jerdi
  • Charbel SaadeEmail author
Original Article • HIP - FRACTURES



The aim of our study is to investigate the results of constrained total hip arthroplasty as a primary treatment of intertrochanteric fractures (ITF) in elderly patients with high comorbidities.

Materials and methods

Total hip replacement (THR) with a retentive cup was performed on 73 patients with ITF over the age of 54 years who had high comorbidities and a Charlson score above five. Short- and long-term complications were determined by follow-up. Bivariate analysis was conducted in order to determine the possible determinants of mortality and factors associated with comorbidity as measured by the Charlson comorbidities index.


Patient demographics that consisted of females (58.9%) (p < 0.04) with the mean age of both males and females demonstrated no statistical significance. The mean hospitalization time and weight bearing time were 11 and 2.67 days, respectively. Only 4.1% needed re-intervention due to re-fracture and none due to prosthesis failure. There was a statistical significance between the comorbidity index and the mortality rate. However, no statistical significance was identified between the comorbidity index and the functional status after constrained THR.


High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for ITF in elderly patients.


Total hip replacement Metallic implant X-ray Intertrochanteric fractures 


Compliance with ethical standards

Conflict of interest

All authors declare that there is no financial, family or any other person related to them that have had any form of involvement in the study other than the authors stated. There are no financial, academic or clinical conflicts when this study was being developed, executed, reviewed, written and submitted to this journal.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Diagnostic Radiology DepartmentAmerican University of Beirut Medical CenterRiad El-Solh, BeirutLebanon
  2. 2.Department of Orthopedic SurgeryGeitaoui Lebanese HospitalBeirutLebanon
  3. 3.Department of Orthopedic SurgeryInstitut de la main Clinique Jouvenet ParisParisFrance

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