A comparative study between gamma nail and percutaneous compression plating for the treatment of intertrochanteric hip fractures.

Abstract

Nowadays, the literature shows better results in the treatment of intertrochanteric (AO/OTA 31.A1-A2) hip fractures with dynamic hip screw (DHS) compared with gamma nail (GN). Besides, percutaneous compression plate (PCCP) gives results which are better or similar to those obtained with DHS. But only two reports compare the results between PCCP and GN. The aim of this trial is to compare the outcome of treatment of these fractures with either a PCCP or a GN. A retrospective trial with 414 patients over 60years of age treated in our institution for 6years, with a minimum follow-up of 1year, was performed to compare the outcome of a PCCP (240) with a GN (174). The post-operative hospital stay was 2days longer in the GN group compared to the PCCP group (p<0.001). The post-operative haemoglobin serum level was slightly lower in the GN group (relative risk (RR) -0.28, 95% confidence interval (CI): -0.02 to -0.54, p=0.036) and the transfusion requirement was lower in the PCCP group (GN 53.4% vs. PCCP 33.8%, p<0.001). The procedure-related complications rate was higher in the GN group (9.8 vs. 5%, p=0.06). PCCP has lower overall economical cost and blood transfusional requirements for a similar or better outcome in terms of procedure-related complications.