Short gamma nail versus dynamic Hip screw in the treatment of unstable trochanteric femoral fractures in the elderly. A comparative study

ABSTRACT

Trochanteric femoral fractures in osteoporotic bone pose a challenge to both the surgeon and the osteosynthesis device. The problem becomes compounded when the fracture is unstable. Thirty consecutive cases of unstable trochanteric fractures were treated surgically using two different methods of internal fixation, 13 cases being treated with the short gamma nail [GN] and 17 cases treated with the dynamic hip screw [DHS]. The average age in the GN group was 67.2 years, while being 66.8 years in the DHS group. Average follow-up was 11.6 months in GN group versus 12 months for the DHS group. Union occurred in all cases of GN [100%] while occurring in 12 of 17 of the DHS [70.6%]. A second procedure was not needed in any of the GN cases, while used in 5 of the DHS cases. Major complication as screw cut out occurred in 5 of the DHS cases with none in the GN cases. Final outcome based on clinical and radiologic data showed superior performance of the short gamma nail compared to the dynamic hip screw in the treatment of unstable trochanteric fractures