Table 10-55Intramedullary vs. extramedullary implants for trochanteric extracapsular fracture - Clinical summary of findings

OutcomeIntramedullaryExtramedullaryRelative riskAbsolute effectQuality
Mortality – 30 days78/712 (11%)56/729 (7.7%)RR 1.44 (1.04 to 1.99)34 more per 1000 (from 3 more to 76 more)High
Mortality – 3 months19/173 (11%)21/173 (10%)RR 0.9 (0.52 to 1.59)12 fewer per 1000 (from 58 fewer to 72 more)Low
Mortality – 1 year186/1005 (18.5%)175/1021 (17.1%)RR 1.09 (0.91 to 1.31)15 more per 1000 (from 15 fewer to 53 more)High
Reoperation – within follow up period of study69/1261 (5.5%)50/1312 (3.8%)RR 1.39 (0.87 to 2.23)15 more per 1000 (from 5 fewer to 47 more)High
Operative or postoperative fracture - within follow up period of study54/1334 (4%)5/1380 (0%)RR 5.61 (2.98 to 10.59)16 more per 1000 (from 7 more to 33 more)Low
Cut-out (at latest follow up)39/1446 (2.7%)42/1508 (2.8%)RR 0.95 (0.63 to 1.45)1 fewer per 1000 (from 10 fewer to 13 more)Moderate
Infection (deep infection or requires reoperation)8/922 (0.9%)10/943 (1%)RR 0.86 (0.38 to 1.93)1 fewer per 1000 (from 7 fewer to 10 more)Moderate
Non-union (at latest follow up)3/610 (0.5%)3/621 (0.5%)RR 1.01 (0.3 to 3.46)0 more per 1000 (from 3 fewer to 12 more)Moderate
Pain (at latest follow up)90/278 (32.4%)90/285 (25.9%)RR 1.03 (0.81 to 1.30)9 more per 1000 (from 60 fewer to 95 more)Low
Length of stay in hospital474482N/AMD 0.54 lower (1.93 lower to 0.84 higher)Moderate
Mean mobility (Parker – Palmer score. At 1 year)274281N/AMD 0.17 higher (0.17 lower to 0.51 higher)High

From: 10, Surgical procedures

Cover of The Management of Hip Fracture in Adults
The Management of Hip Fracture in Adults [Internet].
NICE Clinical Guidelines, No. 124.
National Clinical Guideline Centre (UK).
Copyright © 2011, National Clinical Guideline Centre.

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