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Volume 15
Issue 17
10.3390/jcm15176691
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Comparison of Rehabilitation Outcomes Between Surgical and Conservative Treatments for Incomplete Intertrochanteric Proximal Femur Fractures—A Retrospective Cohort Study

by
Cheuk Kin Kwan
1,
Yu Hei Choi
2,
Rossetti Hiu Yin Lam
1,
Richard Ku
1,
Tsz Hang Ma
1,
Wing Hong Liu
2,
Wing Hoi Cheung
1,
Chaoran Liu
1,
Sheung Wai Law
1,2,3 and
Ronald Man Yeung Wong
1,*
1
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
2
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong SAR, China
3
Department of Orthopaedic Rehabilitation, Tai Po Hospital, Hong Kong SAR, China
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(17), 6691; https://doi.org/10.3390/jcm15176691 (registering DOI)
Submission received: 30 June 2026 / Revised: 17 August 2026 / Accepted: 25 August 2026 / Published: 28 August 2026
(This article belongs to the Section Orthopedics)
Review Reports Versions Notes

Abstract

Background/Objectives: Incomplete intertrochanteric proximal femur fractures pose a management dilemma regarding the choice between surgery and conservative care. This study compared radiographic and functional outcomes between surgical fixation and conservative treatment and evaluated whether immediate full weight-bearing (FWB) can be performed by conservatively managed patients. Methods: This is a retrospective cohort study of consecutive patients aged ≥ 60 who presented with MRI-confirmed incomplete intertrochanteric fractures at a tertiary trauma center and rehabilitation unit from 2010 to 2020. Clinical outcomes were compared between conservatively managed and surgically treated patients. The primary outcome was radiographic bone union at 3 months; the secondary outcomes included secondary displacement, mobility at discharge, hospital length of stay, and mortality at 3 months and 1 year. Results: Forty-two patients met the inclusion criteria: 10 were managed conservatively, and 32 were managed operatively. Baseline age and sex distributions were similar between groups. At 3 months post-injury, bone union rates were 100% in both groups, with no incidences of secondary displacement regardless of whether a course of protected weight-bearing was prescribed. Functional mobility at discharge and length of stay were comparable. Mortality at 3 months and 1 year did not differ significantly between groups. Conclusions: The preliminary findings of this retrospective cohort study demonstrated managing MRI-diagnosed incomplete intertrochanteric proximal femur fractures conservatively to be feasible. Despite the limited sample size, all included patients who were treated conservatively achieved bone union by 3 months without secondary displacement. Their clinical outcomes were also comparable to the outcomes of those who were treated with surgical fixation. However, given the small sample size and lack of randomization, further investigation is warranted before clinical application.
Keywords: geriatric hip fracture; magnetic resonance imaging; conservative management; rehabilitation; early mobilization geriatric hip fracture; magnetic resonance imaging; conservative management; rehabilitation; early mobilization

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MDPI and ACS Style

Kwan, C.K.; Choi, Y.H.; Lam, R.H.Y.; Ku, R.; Ma, T.H.; Liu, W.H.; Cheung, W.H.; Liu, C.; Law, S.W.; Wong, R.M.Y. Comparison of Rehabilitation Outcomes Between Surgical and Conservative Treatments for Incomplete Intertrochanteric Proximal Femur Fractures—A Retrospective Cohort Study. J. Clin. Med. 2026, 15, 6691. https://doi.org/10.3390/jcm15176691

AMA Style

Kwan CK, Choi YH, Lam RHY, Ku R, Ma TH, Liu WH, Cheung WH, Liu C, Law SW, Wong RMY. Comparison of Rehabilitation Outcomes Between Surgical and Conservative Treatments for Incomplete Intertrochanteric Proximal Femur Fractures—A Retrospective Cohort Study. Journal of Clinical Medicine. 2026; 15(17):6691. https://doi.org/10.3390/jcm15176691

Chicago/Turabian Style

Kwan, Cheuk Kin, Yu Hei Choi, Rossetti Hiu Yin Lam, Richard Ku, Tsz Hang Ma, Wing Hong Liu, Wing Hoi Cheung, Chaoran Liu, Sheung Wai Law, and Ronald Man Yeung Wong. 2026. "Comparison of Rehabilitation Outcomes Between Surgical and Conservative Treatments for Incomplete Intertrochanteric Proximal Femur Fractures—A Retrospective Cohort Study" Journal of Clinical Medicine 15, no. 17: 6691. https://doi.org/10.3390/jcm15176691

APA Style

Kwan, C. K., Choi, Y. H., Lam, R. H. Y., Ku, R., Ma, T. H., Liu, W. H., Cheung, W. H., Liu, C., Law, S. W., & Wong, R. M. Y. (2026). Comparison of Rehabilitation Outcomes Between Surgical and Conservative Treatments for Incomplete Intertrochanteric Proximal Femur Fractures—A Retrospective Cohort Study. Journal of Clinical Medicine, 15(17), 6691. https://doi.org/10.3390/jcm15176691

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