Which implant is better for treating reverse obliquity fractures of the proximal femur: A standard or long nail?

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dc.contributor.authorOkcu G.
dc.contributor.authorOzkayin N.
dc.contributor.authorOkta C.
dc.contributor.authorTopcu I.
dc.contributor.authorAktuglu K.
dc.date.accessioned2024-07-22T08:18:50Z
dc.date.available2024-07-22T08:18:50Z
dc.date.issued2013
dc.description.abstractBackground: Reverse obliquity fractures of the proximal femur have biomechanical characteristics distinct from other intertrochanteric fractures and high implant failure rate when treated with sliding hip screws. Intramedullary hip nailing for these fractures reportedly has less potential for cut-out of the lag screw because of their loadbearing capacity when compared with extramedullary implants. However, it is unclear whether nail length influences healing. Questions/purposes: We compared standard and long types of intramedullary hip nails in terms of (1) reoperation (fixation failure), (2) 1-year mortality rate, (3) function and mobility, and (4) union rate. Methods: We conducted a pilot prospective randomized controlled trial comparing standard versus long (≥ 34 cm) intramedullary hip nails for reverse obliquity fractures of the proximal femur from January 2009 to December 2009. There were 15 patients with standard nails and 18 with long nails. Mean age was 79 years (range, 67-95 years). We determined 1-year mortality rates, reoperation rates, Parker-Palmer mobility and Harris hip scores, and radiographic findings (fracture union, blade cut-out, tip-apex distance, implant failure). Minimum followup was 12 months (mean, 14 months; range, 12-20 months). Results: We found no difference in reoperation rates between groups. Two patients (both from the long-nail group) underwent revision surgery because of implant failure in one and deep infection in the other. There was no difference between the standard- and long-nail groups in mortality rate (17% versus 18%), Parker-Palmer mobility score (five versus six), Harris hip score (74 versus 79), union rate (100% in both groups), blade cut-out (zero versus one), and tip-apex distance (22 versus 24 mm). Conclusions: Our preliminary data suggest reverse obliquity fractures of the trochanteric region of the femur can be treated with either standard or long intramedullary nails. Level of Evidence: Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence. © 2013 The Association of Bone and Joint Surgeons®.
dc.identifier.DOI-ID10.1007/s11999-013-2948-0
dc.identifier.issn0009921X
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/17438
dc.language.isoEnglish
dc.publisherSpringer New York LLC
dc.rightsAll Open Access; Green Open Access
dc.subjectaged
dc.subjectclinical article
dc.subjectclinical effectiveness
dc.subjectconference paper
dc.subjectcontrolled study
dc.subjectequipment design
dc.subjectfemale
dc.subjectfemur fracture
dc.subjectfixation failure
dc.subjectfollow up
dc.subjectfracture healing
dc.subjectHarris hip score
dc.subjecthip radiography
dc.subjecthuman
dc.subjectintramedullary nail
dc.subjectmale
dc.subjectmortality
dc.subjectoperation duration
dc.subjectoutcome assessment
dc.subjectParker Palmer mobility score
dc.subjectphysical mobility
dc.subjectpilot study
dc.subjectpriority journal
dc.subjectprospective study
dc.subjectrandomized controlled trial
dc.subjectreoperation
dc.subjectscoring system
dc.subjectsurgical infection
dc.titleWhich implant is better for treating reverse obliquity fractures of the proximal femur: A standard or long nail?
dc.typeConference paper

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