Background: Femur intertrochanteric fractures can be classified into stable and unstable fractures according to their severity. Postoperative complications and mortality were more common in patients with unstable intertrochanteric fractures. However, there has been little effort to evaluate the risk factors of the two fracture types. This study aimed to identify the possible differences in demographic and clinical characteristics of older patients with different types of intertrochanteric fractures.Methods: The medical records of patients aged ≥60 years who presented with intertrochanteric fractures from June 2018 to March 2020 were retrospectively reviewed. Fifty-seven patients were enrolled and divided into two groups according to severity: stable (21 patients) and unstable (36 patients). Demographic data, body mass index (BMI), ambulatory ability prior to fracture, pre-fracture residence, season at fracture, bone mineral density (BMD), and serum 25-hydroxyvitamin D [25(OH)D], osteocalcin, and calcium levels were compared between the two groups. Additionally, we analyzed the correlation among variables.Results: The stable group had significantly higher serum 25(OH)D and calcium levels than the unstable group (p = 0.010, p = 0.019). There were no statistically significant differences (p > 0.05) in age, sex, height, weight, BMI, ambulatory ability prior to fracture, pre-fracture residence, season at fracture, BMD, and serum osteocalcin level between the two groups. In addition, serum 25(OH)D and calcium levels were not correlated with any of the variables in all patients.Conclusion: Low vitamin D and calcium levels are associated with unstable intertrochanteric fracture in elderly patients. Maintaining adequate vitamin D and calcium levels could avoid an increase in the severity of intertrochanteric fractures.
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