Why the study?
Pertrochanteric fractures in the elderly cause disability and loss of independence, and this study aimed to determine functional and radiological outcomes after Dynamic hip screw versus intramedullary Gamma nail fixation.
Does Dynamic hip screw (DHS) compared to intramedullary Gamma nail fixation improve functional and radiological outcomes in patients with pertrochanteric fractures?
Does Dynamic hip screw (DHS) compared to intramedullary Gamma nail fixation improve functional and radiological outcomes in patients with pertrochanteric fractures?
Both Dynamic hip screw and intramedullary Gamma nail fixation provide comparable functional and radiological outcomes for pertrochanteric fractures in the elderly.
Supports comparable outcomes with DHS or Gamma nail; leaves open need for RCTs to confirm fixation choice in pertrochanteric fractures.
Pertrochanteric fractures (PFs) in the elderly and their consequences are among the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence. This article aims to determine the functional and radiological outcomes in a group of patients with PFs treated with either the Dynamic hip screw (DHS) or intramedullary Gamma nail fixation. A total of 618 patients, admitted to hospital for pertrochanteric fractures between 2015 and 2019, at a mean age of 82.40 (range 29–104) were screened. Finally, 78 patients were enrolled. Parameters related to hospital stay and surgery (length of hospital stay, surgery duration) were compared in both groups. Functional outcomes were assessed by the Harris hip score, subjective pain was measured with a visual analogue scale (VAS), and quality of life was evaluated using the EQ-5D-5L questionnaire. The obtained results were evaluated at 3- and 6-month follow-up. Radiographic parameters were measured based on the preoperative and postoperative standing anterior–posterior pelvic radiographs and axial projection of the hip at 6-month follow-up. The results showed no significant difference between groups treated either with DHS or intramedullary Gamma nail fixation within the scope of the variables under study. In conclusion, both analysed methods support the functional symmetry of the musculoskeletal system.
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Gawrońska et al. (2022) studied this question.
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