Abstract
Aim: To compare two implants, the Gamma Nail and the ACE Trochanteric Nail in the treatment of pertrochanteric femoral fractures.
Patients and methods: Sixty patients were randomized on admission to two treatment groups. Thirty patients were treated with the Gamma nail implants , and thirty had intramedullary fixation with ACE Trochanteric NailI . The average age of these patients was 79 years. 22 patients were men and 38 women. 11 fractures were stable and 49 unstable. Patients were followed for 1 year and had a regular clinical and radiological review at 1, 3 and 6 months postoperatively. Operation time, intra-operative blood loss and blood transfusion and complications were recorded. The mobility score was used to assess the preinjury and postoperative mobility status. All the patients were operated within 24 hours after their accident and 39 of them within the first 6 hours.
Results: There were no complications during the surgery. All the patients were mobilized the first 24 hours post operatively irrespectively of the fracture’s type, and weight bearing was permitted as tolerated. The mean follow up time was 8 months (range 6 to 12 months). 3 patients were lost at the follow up and 2 died. Union of the fracture was achieved in all 55 patients. There was no statistically significant difference between the two groups with regard to intraoperative blood loss and the duration of the surgery. There was no mechanical failure of the implants despite the early patients mobilization. All the patients achieved mobility status similar to the preoperative at the latest follow up.
Conclusions: Based on our study, intramedullary nailing of pertrochanteric hip fractures represents a reliable method of treatment. We did not observe any differences in the two patient groups concerning the operation time, the intraoperative blood loss, the postoperative complications and the patients functional status at the latest follow up.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
