Mini-invasive nail versus DHS to fix pertrochanteric fractures: a case-control study

Area of Science:

• Orthopedic surgery
• Trauma management
• Implant technology

Background:

• Trochanteric fractures are commonly treated with dynamic hip screw (DHS) or intramedullary implants.
• Both DHS and intramedullary devices are considered valid treatment options despite potential complications.

Purpose of the Study:

• To compare the efficacy of a sliding screw-plate system (DHS) with a mini-invasive nailing device (BCM nail) for treating trochanteric fractures.
• To evaluate the BCM nail's potential for stable internal fixation and enhanced postoperative functional recovery.

Main Methods:

• A prospective comparative case-control study involving 60 patients (30 per group) over 60 years old with trochanteric fractures.
• Comparison included operative data, postoperative course, functional outcomes, and anatomical healing.
• The BCM nail involved primary cephalic screw insertion followed by mini-invasive nail insertion.

Main Results:

• The DHS group showed less operating time and blood loss (intraoperative and Day 3).
• The BCM nail group had a shorter delay to sitting in a wheelchair and a lower incidence of secondary displacements.
• The BCM nail group demonstrated a superior healing rate at 3 months and a lesser decrease in the Parker score for functional recovery.

Conclusions:

• The BCM nail provides enhanced stability and functional recovery for trochanteric fractures.
• Ancillary difficulties with the mini-invasive technique require refinement.
• Preliminary results support further development of the BCM nail device.