title: A new intramedullary nail device for the treatment of intertrochanteric hip fractures: Perioperative experience.
abstract: BACKGROUND
  Traditional short nail fixation devices used for intertrochanteric (IT) fractures of the femur have several surgeon and patient benefits. However, these devices have had a high incidence of complications. A new intramedullary device designed to overcome these shortcomings has become commercially available. The goal of this study was to compare this intramedullary nail device with the traditional dynamic hip screw.
  
  
  METHODS
  A prospective cohort study with 60 IT hip fractures was performed. Thirty patients treated with the trochanteric fixation nail (TFN) were compared with 30 patients treated with the dynamic hip screw (DHS) during the same time period. Implant selection was dictated by surgeon randomization. Primary outcomes planned for this study were immediate measures of operative blood loss, surgical time, and incidence of operative complications. Secondary outcome of return to preoperative ambulatory status was also recorded. Follow-up for secondary outcomes was conducted at an average of 6 months after surgery. Perioperative, functional, and radiologic outcome measures were collected.
  
  
  RESULTS
  No intra- or perioperative complications occurred with the new nail device. Operative time was 10 minutes shorter with TFN (50.7 minutes) compared with DHS (60.4 minutes). No Trendelenburg gait was noted in either group. No femur fractures or distal locking difficulties occurred in the TFN group. Twelve of 17 (71%) TFN patients returned to prefracture ambulation 6 months after surgery compared with only 6 of 18 (33%) DHS patients (p = 0.09).
  
  
  CONCLUSIONS
  The rate of femoral fractures for short femoral nails was decreased compared with historical controls. Improved early mobilization was noted in TFN group.
authors.affiliation: Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Bienkowski
authors.forename: Rudolf
authors.initials: R
authors.lastname: Reindl
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Berry
authors.forename: Elena
authors.initials: E
authors.lastname: Iakoub
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Harvey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology