title: Complications of short versus long cephalomedullary nail for intertrochanteric femur fractures, minimum 1 year follow-up.
abstract: BACKGROUND
  Hip fractures are becoming increasingly common resulting in significant morbidity, mortality and raising healthcare costs. Both short and long cephalomedullary devices are currently employed to treat intertrochanteric hip fractures. However, which device is optimal continues to be debated as each implant has unique characteristics and theoretical advantages. This study looked to identify rates of complications associated with both long and short cephalomedullary nails for the treatment of intertrochanteric hip fractures.
  
  
  METHODS
  We retrospectively reviewed charts from 2006 to 2011, and we identified 256 patients were identified with AO class 31.1-32.3 fractures. Sixty were treated with short nails and 196 with long nails. Radiographs and charts were then analysed for failures and hardware complications.
  
  
  RESULTS
  Catastrophic failure and hardware complication rates were not statistically different between short or long cephalomedullary nails. The overall catastrophic failure rate was 3.1 %; there was a 5 % failure rate in the short-nail group compared with a 2.6 % failure rate in the long-nail group (p = 0.191). There was a 3.33 % secondary femur fracture rate in the short-nail group, compared with none in the long-nail cohort (p = 0.054). The rate of proximal fixation failure was 1.67 % for the short-nail group and 2.0 % in the long-nail group (p = 0.406).
  
  
  CONCLUSIONS
  Our data suggests equivocal outcomes as measured by similar catastrophic failure rate between both short and long cephalomedullary nails for intertrochanteric femur fractures. However, there was an increased risk of secondary femur fracture with short cephalomedullary nails when compared to long nails that approached statistical significance.
authors.affiliation: Rhode Island Hospital, Providence, Rhode Island, USA, josh.j.vaughn@gmail.com.
authors.forename: Josh
authors.initials: J
authors.lastname: Vaughn
authors.forename: Eric
authors.initials: E
authors.lastname: Cohen
authors.forename: Bryan G
authors.initials: BG
authors.lastname: Vopat
authors.forename: Patrick
authors.initials: P
authors.lastname: Kane
authors.forename: Emily
authors.initials: E
authors.lastname: Abbood
authors.forename: Christopher
authors.initials: C
authors.lastname: Born
mesh_terms: D001858:Bone Nails / Q000009:adverse effects*; D001863:Bone Screws / Q000009:adverse effects; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D057068:Periprosthetic Fractures / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies