Key result
Intramedullary nailing reduced the revision rate compared to fixed angle blade plating in patients with subtrochanteric femoral fractures.
Why the study?
To compare closed intramedullary nailing to open reduction and internal fixation using a fixed angle blade plate for managing subtrochanteric femoral fractures.
Does closed intramedullary nailing reduce revision surgery compared to fixed angle blade plating in patients with acute subtrochanteric femoral fractures?
RCT (n=60)
Open-label
Randomized
Yes
Does closed intramedullary nailing reduce revision surgery compared to fixed angle blade plating in patients with acute subtrochanteric femoral fractures?
Closed intramedullary nailing is superior to fixed-angle blade plating for subtrochanteric femoral fractures, resulting in significantly fewer implant failures and revisions.
Answers are grounded in this paper and cite their sources.
No differences in perioperative metrics; hypothesis-generating and should not change practice for subtrochanteric fractures.
Aim: 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 significant (28%) in the BP group and none in the IN group.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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Sanjeev Gupta (2024) conducted an RCT in Subtrochanteric femoral fractures (n=60). Intramedullary nailing vs. Fixed angle blade plating was evaluated on Revision surgery (p=0.025). Intramedullary nailing reduced the revision rate compared to fixed angle blade plating in patients with subtrochanteric femoral fractures.
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