title: A multicentre, prospective, randomised comparison of the sliding hip screw with the Medoff sliding screw and side plate for unstable intertrochanteric hip fractures.
abstract: OBJECTIVE
  This study aimed to compare the dynamic hip screw (DHS) and Medoff sliding plate (MSP) for unstable intertrochanteric hip fractures.
  
  
  METHODS
  A randomised, prospective trial design was used.
  
  
  METHODS
  The study was undertaken in two level-1 trauma centres and one community hospital.
  
  
  METHODS
  A total of 163 patients with unstable intertrochanteric hip fractures (Orthopaedic Trauma Association (OTA) 31-A2) were randomised to DHS or MSP. Inclusion and exclusion criteria were designed to focus on isolated unstable intertrochanteric hip fractures in ambulatory patients.
  
  
  METHODS
  Randomisation was performed intra-operatively, after placement of a 135° guide wire. Follow-up assessments were performed at regular intervals for a minimum of 6 months.
  
  
  METHODS
  The primary outcome measure was re-operation rate. The secondary outcome was patient function, evaluated using a validated outcome measure, the Hip Fracture Functional Recovery Score. Tertiary outcomes included: mortality, hospital stay, quality of reduction and malunion rate.
  
  
  RESULTS
  A total of 86 patients were randomised to DHS and 77 to MSP. The groups had similar patient demographics, pre-fracture status and in-hospital course. The quality of reduction was the same for each group, but the operative time was longer in the MSP group (61.6 vs. 50.1min, P=0.01). The rate of re-operation was low (3/86 in DHS and 2/77 in MSP) with no statistically significant difference. The functional outcomes were the same for both groups, with functional recovery scores at 6 months of 51.0% in the DHS arm and 49.7% in the MSP arm.
  
  
  CONCLUSIONS
  The two techniques produced similar results for the clinically important outcomes of the need for further surgery and functional status of the patients at 6 months' follow-up.
authors.affiliation: University of British Columbia, Vancouver, BC, Canada. Electronic address: bobmccormack@telus.net.
authors.forename: R
authors.initials: R
authors.lastname: McCormack
authors.forename: K
authors.initials: K
authors.lastname: Panagiotopolous
authors.forename: R
authors.initials: R
authors.lastname: Buckley
authors.forename: M
authors.initials: M
authors.lastname: Penner
authors.forename: B
authors.initials: B
authors.lastname: Perey
authors.forename: G
authors.initials: G
authors.lastname: Pate
authors.forename: T
authors.initials: T
authors.lastname: Goetz
authors.forename: M
authors.initials: M
authors.lastname: Piper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006620:Hip Fractures / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Hip screw; Intertrochanteric fracture; Sliding plate