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J Orthop Trauma. 2002 Jul;16(6):386-93.

Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail.

Author information

  • 1Clinique d'Orthopédie et de Chirurgie de l'Appareil Moteur, Hôpital Cantonal Universitaire, Geneva, Switzerland.

Abstract

OBJECTIVES:

To compare the results between a sliding compression hip screw and an intramedullary nail in the treatment of pertrochanteric fractures.

DESIGN:

Prospective computer-generated randomization of 206 patients into two study groups: those treated by sliding compression hip screw (Group 1; n = 106) and those treated by intramedullary nailing (Group 2; n = 100).

SETTING:

University Level I trauma center.

PATIENTS:

All patients over the age of fifty-five years presenting with fractures of the trochanteric region caused by a low-energy injury, classified as AO/OTA Type 31-A1 and A2.

INTERVENTION:

Treatment with a sliding compression hip screw (Dynamic Hip Screw; Synthes-Stratec, Oberdorf, Switzerland) or an intramedullary nail (Proximal Femoral Nail; Synthes-Stratec, Oberdorf, Switzerland).

MAIN OUTCOME MEASUREMENTS:

Intraoperative: operative and fluoroscopy times, the difficulty of the operation, intraoperative complications, and blood loss. Radiologic: fracture healing and failure of fixation. Clinical: pain, social functioning score, and mobility score.

RESULTS:

The minimum follow-up was one year. We did not find any statistically significant difference, intraoperatively, radiologically, or clinically, between the two groups of patients.

CONCLUSIONS:

There is no advantage to an intramedullary nail versus a sliding compression hip screw for low-energy pertrochanteric fractures AO/OTA 31-A1 and A2, specifically with its increased cost and lack of evidence to show decreased complications or improved patient outcome.

PMID:
12142826
[PubMed - indexed for MEDLINE]
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