INTRATROCHANTERIC FRACTURES: RANDOMIZED PROSPECTIVE COMPARISON OF TREATMENT WITH A DYNAMIC HIP SCREW (DHS) AND ANTEROGRADE INTRAMEDULLARY NAILING (TARGON PF)

Abstract

Purpose of the study: To compare the DHS plate fixation with the Targon PF nail for the treatment of intratro-chanteric fractures.

Material and methods: This was a prospective randomized study including 60 patients hospitalized in the emergency setting between December 2003 and June 2004for intratrochanteric fractures. The AO classification was used. We analyzed: patient status (ASA), operative time (type of implant, duration), the postoperative period (blood loss, radiologic findings, duration of hospital stay, early postoperative complications) and at last follow-up, Harris hip score, date of resumed walking, mortality. Patients were assessed at three months postop. This study included 60 patients, 34 with a Targon PF nail and 26 with a DHS. Mean patient age for nailing was 81 years (SD 12.8, range 23–86); for DHS it was 82 years (SD 9.8; range 47–97).

Results: Mean blood loss was 410 ml with the Targon PF nail and 325 ml with the DHS, a nearly significant difference (p=0.07). The other results did not demonstrate any significant difference. At three months five cases of screw cut out were noted. Bone healing was achieved in all cases. The Trargon PF nail and the DHS provide equivalent results, with less bleeding an lesser cost for the DHS.