Pertrochanteric Fracture of Femur, Unstable Throchanteric Hip Fractures
Conditions
Keywords
Throchanteric Fractures; Gamma nail; InterTAN nail
Brief summary
Objective: compare outcomes of unstable intertrochanteric hip fractures treated with two commercially available implants. Design: retrospective observational cohort of 288 treated with a Gamma® nail and 398 with an InterTAN® nail. Patients were operated between 1997 and 2010. Primary outcomes: satisfactory reduction, optimal cephalic screw placement, and to evaluate the incidence of mechanical complications; secondary measures included the tip-apex distance (TAD), hematocrit (Hto) and hemoglobin (Hb) drop, transfusion requirement and volume, hospital length of stay and the time to first ambulation.
Detailed description
Rationale: to evaluate whether outcomes differ between two commonly used cephalomedullary nails for unstable intertrochanteric hip fractures in routine practice. Setting: double-centre, single-city retrospective cohort with consecutive patients treated by the same surgeon-Gamma2® at the Hospital Clínico Universitario (1997-2002; n=288) and InterTAN® at Vithas Hospitals (2002-2010; n=398). Cohorts: defined by the implant used in usual care; adults ≥65 years with unstable AO/OTA A2-A3 patterns were included; key exclusions were stable patterns, pathologic fractures, subtrochanteric extension, poor radiographs, and \<6-month follow-up. Planned analyses: between-group comparisons of reoperation and implant-related complications (primary focus), plus perioperative and functional parameters, using χ²/t-tests as appropriate adjusting for age, sex, ASA class, AO/OTA pattern, reduction quality, and screw position metrics (e.g., TAD); results reported as effect sizes with 95% CIs, with sensitivity analyses by fracture pattern and reduction quality
Interventions
No differences with the routine surgery for trochanteric fractures
Sponsors
Study design
Eligibility
Inclusion criteria
* Unstable trochanteric fractures confirmed radiographically according to OTA (Orthopedic Trauma Association), treated with Gamma or InterTAN nail, * available follow-up for ≥ 6 months
Exclusion criteria
* Pathological fractures * Polytrauma precluding standard treatment/follow-up * Missing key variables/outcomes
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Implant-related complications | 6 months | Incidence of device-related adverse events (e.g., cut-out, varus collapse). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of fracture reduction | Immediately postoperative (within 24 hours) | Satisfactory or unsatisfactory according to Baumgaertner's criteria |
| Cephalic screw placement | Immediately postoperative (within 24 hours) | Position of the lag screw according to Cleveland-Bosworth quadrants |
Countries
Spain