title: A Multicenter Randomized Control Trial Comparing a Novel Intramedullary Device (InterTAN) Versus Conventional Treatment (Sliding Hip Screw) of Geriatric Hip Fractures.
abstract: OBJECTIVE
  To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT).
  
  
  METHODS
  Prospective, randomized, multicenter clinical trial.
  
  
  METHODS
  Five level 1 trauma centers.
  
  
  METHODS
  Two hundred forty-nine patients 55 years of age or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months.
  
  
  METHODS
  Computer generated randomization to either IT (n = 123) or SHS (n = 126).
  
  
  METHODS
  The Functional Independence Measure (FIM) and the Timed Up and Go test (TUG) were used to measure function and motor performance. Secondary outcome measures included femoral shortening, complications, and mortality.
  
  
  RESULTS
  Demographics, comorbidities, preinjury FIM scores and TUG scores were similar between groups. Patients (17.2%) who received an IT had limb shortening greater than 2 cm compared with 42.9% who received an SHS (P < 0.001). To determine the importance of preinjury function and fracture stability, we analyzed the subgroup of patients with the ability to walk 150 m independently preinjury and an OA/OTA 31A-2 fracture (n = 70). In this subgroup, patients treated with SHS had greater shortening and demonstrated poorer FIM and TUG scores compared with patients treated with an IT.
  
  
  CONCLUSIONS
  Overall, most patients with intertrochanteric femur fractures can expect similar functional results whether treated with an intramedullary or extramedullary device. However, active, functional patients have an improved outcome when the InterTAN is used to treat their unstable intertrochanteric fracture.
  
  
  METHODS
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *London Health Sciences Centre, Victoria Hospital, London, ON, Canada; †Western University, London, ON, Canada; ‡The Ottawa Hospital, Ottawa, ON, Canada; §Royal Columbian Hospital, Fraser Orthopaedic Treatment Clinic, New Westminster, BC, Canada; ‖Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada; ¶Eagle Ridge and Royal Columbian Hospitals, Fraser Orthopaedic Institute, New Westminster, BC, Canada; **Simon Fraser Orthopaedic Fund, Royal Columbian Hospital, New Westminster, BC, Canada; and ††Queen Elizabeth II Centre for Clinical Research, Halifax, NS, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Sanders
authors.forename: Dianne
authors.initials: D
authors.lastname: Bryant
authors.forename: Christina
authors.initials: C
authors.lastname: Tieszer
authors.forename: Abdel-Rahman
authors.initials: AR
authors.lastname: Lawendy
authors.forename: Mark
authors.initials: M
authors.lastname: MacLeod
authors.forename: Steven
authors.initials: S
authors.lastname: Papp
authors.forename: Allan
authors.initials: A
authors.lastname: Liew
authors.forename: Darius
authors.initials: D
authors.lastname: Viskontas
authors.forename: Chad
authors.initials: C
authors.lastname: Coles
authors.forename: Kevin
authors.initials: K
authors.lastname: Gurr
authors.forename: Tim
authors.initials: T
authors.lastname: Carey
authors.forename: Wade
authors.initials: W
authors.lastname: Gofton
authors.forename: Chris
authors.initials: C
authors.lastname: Bailey
authors.forename: Debra
authors.initials: D
authors.lastname: Bartley
authors.forename: Andrew
authors.initials: A
authors.lastname: Trenholm
authors.forename: Trevor
authors.initials: T
authors.lastname: Stone
authors.forename: Ross
authors.initials: R
authors.lastname: Leighton
authors.forename: Julia
authors.initials: J
authors.lastname: Foxall
authors.forename: Mauri
authors.initials: M
authors.lastname: Zomar
authors.forename: Kelly
authors.initials: K
authors.lastname: Trask
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D019544:Equipment Failure Analysis; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000706:statistics & numerical data*; D017102:Fracture Healing; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome