title: Extra- and intramedullary implants for the treatment of pertrochanteric fractures -- results from a Finnish National Database Study of 14,915 patients.
abstract: We analysed registry-based data on 14,915 patients treated for pertrochanteric fracture obtained from the Finnish Health Care Register during the years 1999-2009. Data on the comorbidities, residential status and deaths of the cohort were extracted from several Finnish registries using patients' unique personal identification numbers. The use of intramedullary implants increased substantially during the study period. One-year mortality was slightly higher in the patients treated with intramedullary implant (26.6% vs. 24.9%; P=0.011). In the first year after the fracture, there were more new operations on hip and thigh in patients treated with an intramedullary implant (11.1% vs. 8.9%; P<0.0001). Similarly, there were more new subtrochanteric and diaphyseal fractures of the femur in patients treated with intramedullary implants (3.2% vs. 1.05%; P<0.0001). Our findings suggest that more expensive intramedullary implants do not lead to better clinical outcomes than extramedullary implants for the treatment of pertrochanteric fractures.
authors.affiliation: Department of Orthopedics, Traumatology, and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211 Kuopio, Finland. tero.yli-kyyny@kuh.fi
authors.forename: Tero T
authors.initials: TT
authors.lastname: Yli-Kyyny
authors.forename: Reijo
authors.initials: R
authors.lastname: Sund
authors.forename: Merja
authors.initials: M
authors.lastname: Juntunen
authors.forename: Jari J
authors.initials: JJ
authors.lastname: Salo
authors.forename: Heikki P J
authors.initials: HP
authors.lastname: Kröger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws / Q000706:statistics & numerical data*; D016208:Databases, Factual; D016267:External Fixators; D005260:Female; D005387:Finland / Q000453:epidemiology; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D005594:Fracture Fixation, Intramedullary / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D012042:Registries