title: The long and short of cephalomedullary nails in the treatment of osteoporotic pertrochanteric fracture.
abstract: BACKGROUND
  Pertrochanteric fractures after low-energy trauma are common among osteoporotic patients. Although the use of intramedullary devices to treat such fractures is becoming increasingly popular, there is a paucity of data comparing the outcomes of the use of short cephalomedullary nails (SCN) with the use of long cephalomedullary nails (LCN). This study aimed to compare the outcomes of treatment using LCN with treatment using SCN for patients with osteoporotic pertrochanteric fractures.
  
  
  METHODS
  A retrospective review of 64 patients with osteoporotic pertrochanteric fractures who were treated with either LCN or SCN and had a minimum follow-up of one year was performed. Primary outcome measures include complications, revision surgeries and union rates. Secondary outcome measures include duration of surgery, estimated blood loss, length of hospital stay, and ambulatory and mortality status at one year.
  
  
  RESULTS
  There was no significant difference in the clinical and functional outcomes of the patients who were treated with LCN and those who were treated with SCN. However, there was a higher incidence of heterotopic ossification in the latter group, and a slightly greater average estimated blood loss and duration of surgery in the former group. Patients treated with LCN tended to be more osteoporotic.
  
  
  CONCLUSIONS
  Our study found no significant difference in terms of complications, revision surgeries, union rates and ambulatory status between the patients who were treated with LCN and those who were treated with SCN. Both LCN and SCN provided safe and reliable outcomes in the treatment of osteoporotic pertrochanteric fractures.
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Choon Chiet
authors.initials: CC
authors.lastname: Hong
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Nazrul
authors.initials: N
authors.lastname: Nashi
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Milindu Chanaka
authors.initials: MC
authors.lastname: Makandura
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Jiong Hao Jonathan
authors.initials: JH
authors.lastname: Tan
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Luke
authors.initials: L
authors.lastname: Peter
authors.affiliation: University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Diarmuid
authors.initials: D
authors.lastname: Murphy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: cephalomedullary nails; complications; osteoporosis; pertrochanteric fracture; short versus long nail