A comparative prospective study of dynamic variable angle hip screw and Gamma nail in intertrochanteric hip fractures.
OBJECTIVE
To compare the results between a variable angle dynamic screw-plate(DMS) and the Gamma nail in the treatment of intertrochanteric hip fractures.


METHODS
A comparative prospective study of 142 patients (AO/OTA Type 31-A1; A2; A3 and B2) treated by variable angle dynamic screw-plate (DMS Group = 71) or by intramedullary nailing (Gamma Nail Group = 71).


RESULTS
At the 12-month follow-up, we did not find any statistically significant difference, intraoperatively, radiographically, or clinically, between the two groups of patients, except for shortening. In 12 patients in the DMS group (17%) and in one patient in the Gamma nail group, there was shortening of the operated leg between 1 cm and 3 cm (p = 0.02). In all instances, shortening occurred in patients who sustained A.O. type fractures 31A2. 2 and 3 (19 patients), which are unstable and comminuted.


CONCLUSIONS
The DMS allows effective management of intertrochanteric fractures of the femur. Surgeons should consider choosing surgical treatment according to the type of intertrochanteric fracture. In less comminuted fractures, a compression hip screw may be a faster and safer surgical solution. In comminuted fractures, surgical difficulties may increase in parallel to fracture complexity.
Tarantino
Umberto
U
University of Rome Tor Vergata, Faculty of Medicine and Surgery, Department of Orthopaedics and Traumatology, Rome, Italy.
Oliva
Francesco
F
Impagliazzo
Angelo
A
Mattei
Antonio
A
Cannata
Giuseppe
G
Pompili
Gian Francesco Spurio
GF
Maffulli
Nicola
N
D001858:Bone Nails; D001863:Bone Screws; D004867:Equipment Design; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D005594:Fracture Fixation, Intramedullary; D018460:Fractures, Comminuted / Q000601:surgery; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D016896:Treatment Outcome