Five-Year Outcome Analysis of Intertrochanteric Femur Fractures: A Prospective Randomized Trial Comparing a 2-Screw and a Single-Screw Cephalomedullary Nail. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Berger-Groch, Josephine; Rupprecht, Martin; Schoepper, Steffen; Schroeder, Malte; Rueger, Johannes Maria; Hoffmann, Michael
• Is Part Of: Journal of orthopaedic trauma. Volume 30:Issue 9(2016)
• Publication Date: 2016-09
• Subjects: intertrochanteric fracture -- proximal femoral fracture -- intramedullary nail -- functional outcome -- Harris-Hip-Score -- SF-36; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000616
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To compare the radiological and functional outcome after fixation of intertrochanteric fractures (IF) using either an integrated 2-screw cephalomedullary nail [InterTan (IT); Smith & Nephew] or a single-screw device [Gamma3 (G3); Stryker] with a 5-year follow-up. Design: Prospective, randomized. Settings: A single-center study. Patients: One hundred four patients with a mean age of 81.2 ± 9.2 years were included, 33 patients were available for the final 5-year follow-up, 63 patients died, and 8 patients were lost for follow-up. Intervention: Internal fixation of intertrochaneteric femur fractures using a cephalomedullary nail with either a single screw or an integrated 2-screw system. Main Outcome Measurements: Length of hospital stay, SF-36-questionnaire, Harris-Hip-Score, radiographs. Results: SF-36 index at 6 months indicated that 93% of the IT group returned to their prefracture status compared with only 80% in the G3 group. For the mental health SF-36 index, the IT patients showed a significant increased level 6 months after the index procedure (IT: P = 0.02; G3: P = 0.20). The length of hospital stay was significantly ( P = 0.03) shorter in the IT group. After 5 years however, neither group had significant implant-related complications or differences in terms of functional outcome. Conclusions: Regarding functional outcome and hospital stay, the IT collective performed better in the 6-month follow-up. After 5 years, no significant differences were recorded. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.