A Comparison of Intramedullary and Extramedullary Fixation Devices in Unstable Trochanteric Fractures

Abstract

Objectives: The main objective of the study was to compare functional outcome and complications associated with a proximal femoral nail, an intramedullary device with those of a traditional extramedullary device, the dynamic hip screw, in patients with unstable trochanteric fracture. Method: In this prospective, randomized study, total of 86 patients were randomized to the intramedullary group [Group A ( n = 40)] or the extrmedullary group [Group B ( n = 46)]. All relevant perioperative information and complications were recorded, and assessments of functional outcome were made. Results: The extramedullary group required a longer operative time (p value 0.001) and was associated with greater blood loss (p value 0.002) than the intramedullary group. The re-operation rate as well, was lower in the group A compared with the group B, although there were no statistically significant difference in the overall complication rate between the two groups (p value 0.221). There were no significant differences in functional outcome between both groups. Conclusions: The intramedullary device is useful in the treatment of unstable trochanteric fractures.