Key result
Short intramedullary nail systems provided similar functional outcomes at 12 months compared to long nails, but significantly reduced surgical time and intraoperative blood loss.
Why the study?
In unstable pertrochanteric fractures, complications and long-term benefits of internal fixation using short versus long cephalomedullary nails remain debated.
Does long cephalomedullary nail fixation improve functional outcomes compared to short nail fixation in patients with unstable trochanteric fractures?
Population
61 patients with unstable AO 31-A2 and intertrochanteric AO 31-A3 fractures
Comparison
Short nail system fixation vs long nail system
Design
Randomized prospective single center study
Follow-up
12 months
Authors
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Short nails may be preferred in unstable trochanteric fractures to reduce operative time and blood loss; supports short cephalomedullary fixation over routine long nails.
RCT (n=53)
Single-blind
Sealed envelopes
No
Does long cephalomedullary nail fixation improve functional outcomes compared to short nail fixation in patients with unstable trochanteric fractures?
Absolute Event Rate: 88.53% vs 87.29%
p-value: p=0.15
In patients with unstable trochanteric fractures, long cephalomedullary nails do not improve functional outcomes at 12 months compared to short nails, but are associated with longer surgical times and increased intraoperative blood loss.
Dragosloveanu et al. (2021) conducted an RCT in Unstable pertrochanteric and intertrochanteric fractures (n=53). Short intramedullary nail system vs. Long intramedullary nail system was evaluated on Harris Hip Score (HHS) at 12 months (p=0.15). Short intramedullary nail systems provided similar functional outcomes at 12 months compared to long nails, but significantly reduced surgical time and intraoperative blood loss.
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