title: Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur.
abstract: OBJECTIVE
  The purpose of this prospective randomised trial was to assess whether an intramedullary nail is superior to a sliding hip screw in the treatment of multifragmentary intertrochanteric fractures
  
  
  METHODS
  Eighty patients with a 31-A2.2 or A2.3 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) intertrochanteric fracture were randomly allocated to fixation with either the Gamma nail or the AMBI sliding hip screw device.
  
  
  RESULTS
  All patients were followed up at one, three, six and 12 months postoperatively, except for nine who died. There was no statistical difference in Parker mobility score between groups. The Gamma nail group had significantly higher Barthel Index and EuroQol-5D (EQ-5D) scores than the AMBI group at 12 months. At the same time, the EQ-5D score had returned to its pre-operative values in the Gamma nail group but not in the AMBI group. There were no differences in mortality, radiation time and hospital stay. Duration of the operation, incision length and hip pain occurrence were significantly less in the Gamma nail group.
  
  
  CONCLUSIONS
  Few failures occur when unstable 31-A2.2 and A2.3 AO/OTA fractures are fixed with a sliding hip screw. Nevertheless, an intramedullary nail seems superior in reconstituting patients to their pre-operative state.
authors: 'E Orthopaedic Department, KAT General Hospital, Athens, Attica, Greece, aktselis@hotmail.com.
authors: Ioannis
authors: I
authors: Aktselis
authors: Constantine
authors: C
authors: Kokoroghiannis
authors: Evaggelos
authors: E
authors: Fragkomichalos
authors: Georgios
authors: G
authors: Koundis
authors: Anastasios
authors: A
authors: Deligeorgis
authors: Emmanouil
authors: E
authors: Daskalakis
authors: John
authors: J
authors: Vlamis
authors: Nikolaos
authors: N
authors: Papaioannou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D006615:Hip / Q000000981:diagnostic imaging / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology; D011446:Prospective Studies; D011859:Radiography; D015996:Survival Rate; D016896:Treatment Outcome