title: Clinical and Radiologic Outcomes among Bipolar Hemiarthroplasty, Compression Hip Screw and Proximal Femur Nail Antirotation in Treating Comminuted Intertrochanteric Fractures.
abstract: OBJECTIVE
  In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]).
  
  
  METHODS
  We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening).
  
  
  RESULTS
  There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000).
  
  
  CONCLUSIONS
  There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH<PFNA<CHS).
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, Korea.
authors.forename: You-Sung
authors.initials: YS
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea.
authors.forename: Jae-Hwi
authors.initials: JH
authors.lastname: Nho
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea.
authors.forename: Seong-Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea.
authors.forename: Sijohn
authors.initials: S
authors.lastname: Hong
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul, Korea.
authors.forename: Hyung-Suk
authors.initials: HS
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan, Korea.
authors.forename: Jong-Seok
authors.initials: JS
authors.lastname: Park
keywords: Bipolar hemiarthroplasty; Compression hip screw; Intertrochanteric fracture; Proximal femur nail antirotation