Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures.
One hundred thirty-one patients (135 fractures) who sustained an intertrochanteric fracture were assigned randomly to treatment with either a sliding hip screw or an intramedullary hip screw and followed up prospectively. In patients with unstable intertrochanteric fractures, the intramedullary device was associated with 23% less surgical time and 44% less blood loss; however, use of the intramedullary hip screw in patients who had a stable fracture pattern required 70% greater fluoroscopic time. Intraoperative complications occurred exclusively in patients in the intramedullary hip screw group. There were no differences in the rates of functional recovery between the two fixation groups.
Baumgaertner
M R
MR
Department of Orthopaedics and Rehabilitation, School of Medicine, Yale University, New Haven, CT 06520, USA.
Curtin
S L
SL
Lindskog
D M
DM
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001860:Bone Plates; D001863:Bone Screws; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015641:Radiography, Interventional; D013997:Time Factors; D016896:Treatment Outcome