A comparative prospective study of dynamic variable angle hip screw and Gamma nail in intertrochanteric hip fractures

Purpose: To compare the results between a variable angle dynamic screw-plate(DMS) and the Gamma nail in the treatment of intertrochanteric hip fractures. Methods: A comparative prospective study of 142 patients (AO OTA Type 31-A1; A2; A3 and B2) treated by variable angle dynamic screw-plate (DMS Gro...

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Bibliographic Details
Published in:Disability and rehabilitation 2005-01, Vol.27 (18-19), p.1157-1165
Main Authors: Tarantino, Umberto, Oliva, Francesco, Impagliazzo, Angelo, Mattei, Antonio, Cannata, Giuseppe, Pompili, Gian Francesco Spurio, Maffulli, Nicola
Format: Article
Language:English
Subjects:
Bone Nails
Bone Screws
Equipment Design
Fracture Fixation, Internal - adverse effects
Fracture Fixation, Internal - instrumentation
Fracture Fixation, Intramedullary
Fractures, Comminuted - surgery
Gamma nail
Hip Fractures - surgery
Humans
Intertrochanteric hip fractures
Intraoperative Complications - epidemiology
Prospective Studies
Treatment Outcome
variable angle hip screw
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Summary:Purpose: To compare the results between a variable angle dynamic screw-plate(DMS) and the Gamma nail in the treatment of intertrochanteric hip fractures. Methods: A comparative prospective study of 142 patients (AO OTA Type 31-A1; A2; A3 and B2) treated by variable angle dynamic screw-plate (DMS Group = 71) or by intramedullary nailing (Gamma Nail Group = 71). Results: At the 12-month follow-up, we did not find any statistically significant difference, intraoperatively, radiographically, or clinically, between the two groups of patients, except for shortening. In 12 patients in the DMS group (17%) and in one patient in the Gamma nail group, there was shortening of the operated leg between 1 cm and 3 cm (p = 0.02). In all instances, shortening occurred in patients who sustained A.O. type fractures 31A2. 2 and 3 (19 patients), which are unstable and comminuted. Conclusions: The DMS allows effective management of intertrochanteric fractures of the femur. Surgeons should consider choosing surgical treatment according to the type of intertrochanteric fracture. In less comminuted fractures, a compression hip screw may be a faster and safer surgical solution. In comminuted fractures, surgical difficulties may increase in parallel to fracture complexity.
ISSN:0963-8288
1464-5165
DOI:10.1080/09638280500055875