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Fixation of intertrochanteric hip fractures: gamma nail versus dynamic hip screw. A randomized, prospective study
P J O'Brien1, R N Meek, P A Blachut
1Department of Orthopedics, University of British Columbia, Vancouver Hospital. BC.
Objective:
To compare the efficacy of the gamma nail (GN) to the dynamic hip screw (DHS) in the management of intertrochanteric hip fractures.
Design:
Randomized, prospective clinical trial with a mean follow-up of 52 weeks (range from 11 to 82 weeks).
Setting:
A university teaching hospital.
Patients:
One hundred and one patients with 102 fractures: 49 fractures were treated with the DHS and 53 fractures were treated with the GN.
Interventions:
Fracture fixation with the DHS or the GN.
Main Outcome Measures:
Comparison of duration of operation, blood loss, early and late complications, functional outcome and duration of hospital stay.
Results:
There was no significant difference between the two groups with respect to intraoperative blood loss, days in hospital, time to union and eventual functional outcome. The length of the procedure and fluoroscopy time were longer for the GN group.
Conclusions:
Both the GN and the DHS can be used effectively for the treatment of intertrochanteric fractures. In this study the DHS was associated with a lower risk of local complications and should still be considered to be the implant of choice for patients with intertrochanteric fractures.