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Clinical Orthopaedics and Related Research®

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Open Access 01-04-2013 | Clinical Research

Intramedullary Nails Result in More Reoperations Than Sliding Hip Screws in Two-part Intertrochanteric Fractures

Authors: Kjell Matre, MD, Leif Ivar Havelin, MD, PhD, Jan-Erik Gjertsen, MD, PhD, Birgitte Espehaug, MSc, PhD, Jonas Meling Fevang, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2013

Abstract

Background

Sliding hip screws (SHSs) and intramedullary (IM) nails are well-documented implants for simple two-part intertrochanteric fractures; however, there is no consensus regarding which type of implant is better.

Questions/purposes

We asked whether patients with simple two-part intertrochanteric fractures treated with IM nailing had (1) a lower reoperation rate and (2) less pain and better quality of life than patients treated with SHSs.

Methods

We used data from the Norwegian Hip Fracture Register on 7643 operations for simple two-part intertrochanteric fractures (AO/OTA Type A1) treated with an SHS (n = 6355) or an IM nail (n = 1288) between 2005 and 2010. Kaplan-Meier analysis was used to assess reoperation percentages and a Cox regression model was used to assess the risk of reoperation. Questionnaires regarding pain and quality of life were answered by the patients at 4, 12, and 36 months postoperatively.

Results

We found an increased risk of reoperation after IM nailing within 1 postoperative year: 2.4% and 4.2% for SHS and IM nails, respectively. The difference persisted with time: 4.5% and 7.1% at 3 years. We also found minor differences for pain and quality of life which we judged clinically unimportant.

Conclusions

Based on our findings and a critical review of the literature, we suggest an SHS is likely the preferred implant for simple two-part intertrochanteric fractures.

Level of Evidence

Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

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Title: Intramedullary Nails Result in More Reoperations Than Sliding Hip Screws in Two-part Intertrochanteric Fractures
Authors: Kjell Matre, MD
Leif Ivar Havelin, MD, PhD
Jan-Erik Gjertsen, MD, PhD
Birgitte Espehaug, MSc, PhD
Jonas Meling Fevang, MD, PhD
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 4/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2728-2

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Intramedullary Nails Result in More Reoperations Than Sliding Hip Screws in Two-part Intertrochanteric Fractures

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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