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Randomized trial demonstrates reduced revision rates in subtrochanteric femoral fractures, indicating intramedullary nailing is superior to fixed angle blade plating.
PURPOSE: To compare closed intramedullary nailing to open reduction and internal fixation using a fixed angle blade plate for the management of subtrochanteric femoral fractures. METHODS: 58 patients were equally randomised to undergo either an intramedullary nailing (IN) or fixed angle blade plating (BP). RESULTS: There were no significant differences between the 2 groups with regard to age, time to surgery, operating time, receipt of blood transfusions, duration of hospital stay, or fracture classification. The revision rate was 28% (8/29) in the BP group and none in the IN group; the difference was statistically significant. CONCLUSION: Internal fixation using a fixed angle blade plate for subtrochanteric femoral fractures has higher implant failure and revision rates, compared to closed intramedullary nailing.
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Rahme et al. (2007) studied this question.
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