Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail. A randomised study comparing post-operative rehabilitation

J Bone Joint Surg Br. 2005 Jan;87(1):76-81.

Abstract

We treated 108 patients with a pertrochanteric femoral fracture using either the dynamic hip screw or the proximal femoral nail in this prospective, randomised series. We compared walking ability before fracture, intra-operative variables and return to their residence. Patients treated with the proximal femoral nail (n = 42) had regained their pre-operative walking ability significantly (p = 0.04) more often by the four-month review than those treated with the dynamic hip screw (n = 41). Peri-operative or immediate post-operative measures of outcome did not differ between the groups, with the exception of operation time. The dynamic hip screw allowed a significantly greater compression of the fracture during the four-month follow-up, but consolidation of the fracture was comparable between the two groups. Two major losses of reduction were observed in each group, resulting in a total of four revision operations. Our results suggest that the use of the proximal femoral nail may allow a faster post-operative restoration of walking ability, when compared with the dynamic hip screw.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Nails*
  • Bone Screws*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Fracture Fixation, Internal / rehabilitation
  • Fracture Fixation, Intramedullary / rehabilitation
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / rehabilitation
  • Hip Fractures / surgery*
  • Humans
  • Male
  • Prospective Studies
  • Radiography
  • Recovery of Function
  • Treatment Outcome
  • Walking