Comparison of InterTan and Gamma-3 nails in treatment of intertrochanteric fracture in the elderly

Abstract

Objective To compare clinical outcomes of InterTan and Gamma-3 nails in treatment of intertrochanteric fractures in the elderly.Methods We retrospectively compared the 50 old patients with intertrochanteric fracture who had been treated in our department from May to December 2010.Half of them were treated with InterTan nails and half with Gamma-3 nails.In the InterTan group,there were 9 men and 16 women,with an average age of 78.4 ± 6.1 years; there were 8 Al fractures,15 A2 ones and 2 A3 ones according to the AO classification.In the Gamma group,there were 7 men and 18 women,with an average age of 79.2 ±7.8 years; there were 10 A1 fractures,13 A2 ones and 2 A3 ones according to the AO classification.The 2 groups were compared in terms of operative time,intraoperative blood loss,fracture healing time,Harris hip score and complications.Results Twenty-three patients in each group were followed up for an average of 13.4 months and 13.6 months respectively.The operative time was 71.5 ± 19.3 minutes and 61.3 ± 13.9 minutes respectively for the InterTan and Gamma groups,with a significant difference (P ＜0.05).However,there were no significant differences between the 2 groups regarding blood loss (183.9 ± 69.3 mL vs.182.1 ±68.8 mL),fracture healing time (3.1 ±0.8 months vs.3.1 ±0.6 months),Harris hip score (83.7 ±5.7 points vs.82.2 ±6.4 points),or complication rate [8.7％ (2/23) vs.13.0％ (3/23)] (P ＞0.05).Conclusions Both InterTan and Gamma-3 nails can be used to treat femoral intertrochanteric fractures in the elderly patients,resulting in good clinical outcomes.InterTan nails may have a biomechanical advantage for patients with serious osteoporosis or comminuted fractures while Gamma-3 nails may be a better choice for patients with poor operative tolerance. Key words: Hip fractures; Bone nails; Fractures fixation, intramedullary; Retrospective studies