Comparing two intramedullary devices for treating trochanteric fractures: a prospective study.
BACKGROUND
Intertrochanteric fractures are surgically treated by using different methods and implants. The optional type of surgical stabilization is still under debate. However, between devices with the same philosophy, different design characteristics may substantially influence fracture healing. This is a prospective study comparing the complication and final functional outcome of two intramedullary devices, the intramedullary hip screw (IMHS) and the ENDOVIS nail.


METHODS
Two hundred fifteen patients were randomized on admission in two treatment groups. Epidemiology features and functional status was similar between two treatment groups. Fracture stability was assessed according to the Evan's classification. One hundred ten patients were treated with IMHS and 105 with ENDOVIS nail.


RESULTS
There were no significant statistical differences between the two groups regarding blood loss, transfusion requirements and mortality rate. In contrast, the number of total complications was significantly higher in the ENDOVIS nail group. Moreover, the overall functional and walking competence was superior in the patients treated with the IMHS nail.


CONCLUSIONS
These results indicate that the choice of the proper implant plays probably an important role in the final outcome of surgical treatment of intertrochanteric fractures. IMHS nail allows for accurate surgical technique, for both static and dynamic compression and high rotational stability. IMHS nail proved more reliable in our study regarding nail insertion and overall uncomplicated outcome.
Makridis
Konstantinos G
KG
Orthopaedic Surgeon, Resident, Department of Orthopaedic Surgery, General Hospital of Volos, Polimeri 134, 38222 Greece. kmakrid@yahoo.gr
Georgaklis
Vasileios
V
Georgoussis
Miltiadis
M
Mandalos
Vasileios
V
Kontogeorgakos
Vasileios
V
Badras
Leonidas
L