title: Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation.
abstract: We treated 108 patients with a pertrochanteric femoral fracture using either the dynamic hip screw or the proximal femoral nail in this prospective, randomised series. We compared walking ability before fracture, intra-operative variables and return to their residence. Patients treated with the proximal femoral nail (n = 42) had regained their pre-operative walking ability significantly (p = 0.04) more often by the four-month review than those treated with the dynamic hip screw (n = 41). Peri-operative or immediate post-operative measures of outcome did not differ between the groups, with the exception of operation time. The dynamic hip screw allowed a significantly greater compression of the fracture during the four-month follow-up, but consolidation of the fracture was comparable between the two groups. Two major losses of reduction were observed in each group, resulting in a total of four revision operations. Our results suggest that the use of the proximal femoral nail may allow a faster post-operative restoration of walking ability, when compared with the dynamic hip screw.
authors.affiliation: Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Pajarinen
authors.forename: J
authors.initials: J
authors.lastname: Lindahl
authors.forename: O
authors.initials: O
authors.lastname: Michelsson
authors.forename: V
authors.initials: V
authors.lastname: Savolainen
authors.forename: E
authors.initials: E
authors.lastname: Hirvensalo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000534:rehabilitation; D005594:Fracture Fixation, Intramedullary / Q000534:rehabilitation; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function; D016896:Treatment Outcome; D016138:Walking