title: Treatment of pertrochanteric fractures (OTA 31-A1 and A2): long versus short cephalomedullary nailing.
abstract: OBJECTIVE
  To retrospectively compare the clinical outcomes in patients with pertrochanteric femur fractures without subtrochanteric extension (OTA 31-A1 and A2) after treatment with short or long cephalomedullary nails.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Academic level I trauma center.
  
  
  METHODS
  Two hundred eighty three adult patients presenting with simple or multifragmentary pertrochanteric femur fractures (OTA 31-A1 and A2) between 2004 and 2009 qualified for inclusion in this study.
  
  
  METHODS
  One hundred patients were treated with a short cephalomedullary nail and 183 with a long cephalomedullary nail.
  
  
  METHODS
  Patient demographics and medical comorbidities were recorded for each patient via an electronic medical record. Treatment-related variables including the American Society of Anesthesiologists (ASA) score, duration of surgery, volume of intraoperative blood loss, need for blood products, treatment-related complications, and mortality were recorded and compared between the short and long nail groups.
  
  
  RESULTS
  There were no significant difference between treatment modalities, complication, and reoperation rates for the 2 groups. Treatment with a long nail resulted in subtle increases in procedure time and blood loss.
  
  
  CONCLUSIONS
  No differences in the union and complication rates between the 2 groups were identified, suggesting that long nails offer no advantage compared with short nails for stabilizing simple and multifragmentary pertrochanteric femur fractures without subtrochanteric extension (OTA 31-A1 and A2).
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. hzy707@yahoo.com.cn
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Hou
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Bowen
authors.forename: Kaan S
authors.initials: KS
authors.lastname: Irgit
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Matzko
authors.forename: Cassondra M
authors.initials: CM
authors.lastname: Andreychik
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Horwitz
authors.forename: Wade R
authors.initials: WR
authors.lastname: Smith
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D019544:Equipment Failure Analysis; D005260:Female; D005264:Femoral Fractures / Q000401:mortality* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000401:mortality*; D015995:Prevalence; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome