Implantation of Gamma nail and proximal femoral nail for the treatment of femoral intertrochanteric fractures in the elderly: A randomized follow-up for 131 cases / 中国组织工程研究

ABSTRACT

OBJECTIVE: To compare the clinical effect between Gamma nail and proximal femoral nail (PFN) on the treatment for femoral intertrochanteric fractures in the elderly.METHODS: A total of 131 cases (39 males and 92 females; aged 70?81 years, mean age of 76 years) with femoral intertrochanteric fractures were collected from the Department of Orthopaedics, the Affiliated Changhai Hospital of the Second Military Medical University of Chinese PLA from January 2005 to January 2008. Femoral intertrochanteric fractures were classified based on AO system, including type A1 (n=56) and type A2 (n=75). All cases were randomly divided into Gamma nail group (n=65) and PFN group (n=66). Pre- and post-operative blood loss, blood transfusion volume, operating time, and length of stay were recorded, while the complications were detected following nail implantation. Functional changes of injured limbs were detected after 9 months.RESULTS: At 9 months after following up, there was no significant difference in blood loss, blood transfusion volume, operating time, and length of stay between the two groups before and after implantation (P> 0.05). Furthermore, complications did not occur during or after implantation. Six cases in the PFN group had infection in which of them had diabetes mellitus. There were no complications such as cutting out of femoral head, femoral shaft fractures, breakage of internal device or pushing out phenomenon. All cases got bone union at the final follow-up of nine months and did not get nonunion, delayed union of fractures or shortening of injured extremity.CONCLUSION: Gamma nail and PFN have equal effect on the treatment of femoral intertrochanteric fractures in the elderly.