Long Distally Unlocked Hip Nails Versus Short Distally Locked Nails for Peritrochanteric Fractures: Operative...

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Biomedical Engineering

Background:

• Peritrochanteric hip fractures are common, particularly in elderly populations.
• Intramedullary nailing is a standard surgical treatment for these fractures.
• The choice between long distally unlocked (LUIMNs) and short distally locked (SLIMNs) nails may impact outcomes.

Purpose of the Study:

• To compare surgical time between LUIMNs and SLIMNs for peritrochanteric hip fractures.
• To evaluate secondary outcomes including blood loss, peri-implant fractures, reoperations, and mortality.
• To determine the optimal intramedullary nail type for improved patient outcomes.

Main Methods:

• Retrospective cohort study including 744 patients (602 LUIMNs, 142 SLIMNs) with OTA/AO 31A1-A3 fractures.
• Data collected from one Level I Trauma Center and one community hospital.
• Primary outcome: surgical time; Secondary outcomes: EBL, peri-implant fractures, reoperations, mortality.

Main Results:

• Average operative time was shorter for LUIMNs (46.9 min) than SLIMNs (53.7 min) (P < 0.001).
• Peri-implant fracture rates were significantly lower for LUIMNs (0.6%) compared to SLIMNs (4.1%) (P = 0.012).
• No significant differences were observed in EBL, reoperation rates, or mortality between the two groups.

Conclusions:

• LUIMNs offer reduced operative times and a lower risk of peri-implant fractures compared to SLIMNs for peritrochanteric hip fractures.
• LUIMNs may be a preferred treatment option to mitigate the risk of subsequent fractures.
• Further research could explore long-term functional outcomes and cost-effectiveness.