title: Proximal femoral nail shows better concordance of gait analysis between operated and uninjured limbs compared to hemiarthroplasty in intertrochanteric femoral fractures.
abstract: OBJECTIVE
  The purpose of this study was to compare the results of pedobarographic gait analysis between the patients treated by proximal femoral nail or bipolar partial hemiarthroplasty due to intertrochanteric fractures.
  
  
  METHODS
  Thirty-seven patients with a minimum 1-year follow-up who had been operated for intertrochanteric fractures were evaluated clinically, radiologically and with pedobarographic gait analysis. Proximal femoral nail had been performed to 21 patients (group A), whilst 16 patients had been operated by partial bipolar hemiarthroplasty (group B). Pedobarographic analysis was performed by measuring plantar pressure, force and contact area values in both static and dynamic manner. Pedobarographic results of operated limb were compared among groups. Same data's also were compared between operated and uninjured limbs in each group to determine any asymmetry on weight-bearing.
  
  
  RESULTS
  Average follow-up period in group A and group B was 36 (12-56) and 30 (12-48) months, respectively. There were no statistically significant differences among groups in terms of age, gender, body mass index, type and side of fracture, follow-up period, leg length discrepancy and postoperative hip scores. When the pedobarographic results of operated limb were compared, group B showed much more plantar force and pressure values than group A, on both static and dynamic evaluations. If the evaluation was taken into consideration to comparison of pedobarographic results between operated and uninjured limbs in each group, we found asymmetry in static load bearing, caused by higher load on uninjured limb in both groups. However, there was no statistically significant asymmetry between operated and uninjured limbs in respect to dynamic pedobarographic parameters for patients in group A. On the contrary, operated limbs in group B exposed much more plantar force and pressure values than uninjured limbs, which indicated asymmetric weight-bearing on dynamic evaluation.
  
  
  CONCLUSIONS
  Assessment of pedobarographic parameters can be another way of measuring the results of treatment in intertrochanteric fractures. Uninjured limbs of patients expose much more loading than operated limbs in postoperative static evaluation for both treatment options. However in dynamic evaluation, there is a better concordance of gait analysis between both limbs in patients operated by proximal femoral nail.
authors.affiliation: Yeditepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: maguven2000@gmail.com.
authors.forename: Melih
authors.initials: M
authors.lastname: Güven
authors.affiliation: Ankara Training and Research Hospital, Orthopaedics and Traumatology Clinic, Ulucanlar, Ankara, Turkey. Electronic address: onurkocadal@gmail.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Kocadal
authors.affiliation: Yeditepe University, Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: drbudakakman@hotmail.com.
authors.forename: Budak
authors.initials: B
authors.lastname: Akman
authors.affiliation: Istanbul Medeniyet University, Göztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: opoyanli@yahoo.com.
authors.forename: Oğuz S
authors.initials: OS
authors.lastname: Poyanlı
authors.affiliation: Istanbul Medeniyet University, Göztepe Training and Research Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey. Electronic address: bahattinkemah.md@gmail.com.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Kemah
authors.affiliation: Istanbul Arel University, Vocational School, Department of Physiotherapy, Istanbul, Turkey. Electronic address: evrenfehmiatay@arel.edu.tr.
authors.forename: Evren Fehmi
authors.initials: EF
authors.lastname: Atay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D017102:Fracture Healing; D005684:Gait / Q000502:physiology*; D062785:Hemiarthroplasty / Q000379:methods; D006620:Hip Fractures / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007870:Leg Length Inequality / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D016474:Weight-Bearing
keywords: Asymmetric weight bearing; Bipolar partial hemiarthroplasty; Gait analysis; Intertrochanteric femoral fracture; Pedobarography; Proximal femoral nail; Treatment