Similar function and complications for patients with short versus long hip nailing for unstable pertrochanteric fractures

Ioannis P Galanopoulos; Andreas F Mavrogenis; Panayiotis D Megaloikonomos; Christos T Vottis; Evanthia Mitsiokapa; Panayiotis Koulouvaris; Dimitrios S Mastrokalos; Panayiotis J Papagelopoulos; Vasilios A Kontogeorgakos

doi:10.1051/sicotj/2018023

Similar function and complications for patients with short versus long hip nailing for unstable pertrochanteric fractures

SICOT J. 2018:4:23. doi: 10.1051/sicotj/2018023. Epub 2018 Jun 15.

Authors

Ioannis P Galanopoulos¹, Andreas F Mavrogenis¹, Panayiotis D Megaloikonomos¹, Christos T Vottis¹, Evanthia Mitsiokapa¹, Panayiotis Koulouvaris¹, Dimitrios S Mastrokalos¹, Panayiotis J Papagelopoulos¹, Vasilios A Kontogeorgakos¹

Affiliation

¹ First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece.

Abstract

Purpose: To compare short with long intramedullary hip nailing for elderly patients with unstable pertrochanteric fractures.

Methods: We prospectively studied 50 patients (33 women, 17 men; mean age, 80 years; range, 74-93 years) with unstable pertrochanteric fractures admitted and treated with a short (group A) or a long (group B) intramedullary hip nail from January 2013 to 2017. The patients were randomly allocated into each group according to their order of admission. The mean follow-up was 2 years (range, 1-5 years). We evaluated operative time, function, fracture healing, varus/valgus loss of reduction, and distance between the distal line of the fracture and the distal locking screw of the nail.

Results: Operative time was significantly shorter in group A. Function, fracture healing and varus/valgus loss of reduction was similar between the two groups. The mean distance between the distal fracture line and distal locking screw was 7.2 cm (range, 3-10 cm) in patients of group A; in all patients of group B, an appropriate nail length was chosen so that the distal locking screw was inserted at least 3 times the diameter of the bone at the distal fracture line. Complications included periprosthetic fracture (one patient of group A), and z-effect phenomenon (one patient of group B); complications rate was similar between the two groups.

Conclusion: Short intramedullary hip nailing is associated with similar function and complications, but shorter operative time compared to long intramedullary hip nails for patients with unstable pertrochanteric fractures.