title: Reverse Oblique and Transverse Intertrochanteric Femoral Fractures Treated With the Long Cephalomedullary Nail.
abstract: OBJECTIVE
  To evaluate the healing rate, complications, role of reduction and screw placement, and the 1-year mortality in the treatment of reverse oblique and transverse intertrochanteric femoral fractures treated with the long cephalomedullary nail.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Two different Level-1 trauma centers: Geisinger Medical Center and the University of Utah.
  
  
  METHODS
  One hundred forty-eight patients with intertrochanteric fractures (AO/OTA class 31-A3) eligible for review. All patients had a minimum of 12 months of follow-up and were available for radiologic checks and assessment of outcomes and complications.
  
  
  METHODS
  Long cephalomedullary nail.
  
  
  METHODS
  Medical records were reviewed for reoperation, demographic parameters, length of hospital stay, estimated blood loss, and need for transfusion. Mortality rates at 1 month, 6 months, and 1 year were also recorded. Patients were followed clinically and radiographically at 6 weeks, 3 months, 6 months, 12 months, and yearly as needed.
  
  
  RESULTS
  The average age of patients was 69.9 (range, 19-95) years. Average length of follow-up was 53 (range, 12-148) months. The average surgical time was 71.8 (range, 26-229) minutes. Twenty-four patients (16%) required blood transfusions, and the average transfusion required was 205.1 mL (range, 20-800). Five different long nail designs were used to treat the patients. One patient (0.6%) experienced an intraoperative complication. Eighteen patients (12%) sustained postoperative complications. Twelve (8%) patients required reoperations. One-year mortality rates were 10.1%.
  
  
  CONCLUSIONS
  Long cephalomedullary nails remain the preferred treatment option for the treatment of 31-A3-type fractures, demonstrating acceptable complication rates, low reoperation rates, and high rates of healing.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery, Liv Hospital, Istanbul, Turkey; †Department of Orthopaedic Surgery, Geisinger Clinic, Danville, PA; and ‡University of Utah Health Care Orthopaedic Center, Salt Lake City, UT.
authors.forename: Kaan
authors.initials: K
authors.lastname: Irgit
authors.forename: Raveesh D
authors.initials: RD
authors.lastname: Richard
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Beebe
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Bowen
authors.forename: Erik
authors.initials: E
authors.lastname: Kubiak
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Horwitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion / Q000401:mortality; D001858:Bone Nails / Q000706:statistics & numerical data*; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000401:mortality* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014589:Utah; D055815:Young Adult