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July 31, 2008Journal of Bone and Joint Surgery - British Volume

A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip

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Why the study?

Does the Holland nail improve peri-operative and post-operative outcomes compared to a dynamic hip screw in patients with intertrochanteric hip fractures?

Population

190 patients with an extra-capsular hip fracture (intertrochanteric fracture of the femoral neck)

Comparison

Operative stabilisation with a long… vs Operative stabilisation with a dynamic hip screw

Design

RCT, randomised

Follow-up

one year

Authors

NLN. J. LITTLERoyal Surrey County HospitalVVVinit VermaPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesCFCecil FernandoSri Devaraj Urs Medical College

Discussion

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Implication

Holland nail lowers blood loss and transfusion needs versus DHS despite longer surgery; extends RCT evidence guiding implant choice in intertrochanteric fractures.

Structured PICO

Does the Holland nail improve peri-operative and post-operative outcomes compared to a dynamic hip screw in patients with intertrochanteric hip fractures?

P
Population
190 patients with an extra-capsular hip fracture (intertrochanteric fracture of the femoral neck)
I
Intervention
Operative stabilisation with a long intramedullary Holland nail
C
Comparator
Operative stabilisation with a dynamic hip screw (DHS)
O
Outcome
Peri-operative and post-operative variables including anaesthetic time, operating time, radiation time, blood loss, time to mobilising, wound infection, time to discharge, time to fracture union, and mortality

The Holland nail results in less blood loss and faster mobilisation compared to the dynamic hip screw for intertrochanteric hip fractures, despite longer operation times.

Cite This Study

LITTLE et al. (2008) studied this question.

synapsesocial.com/papers/6a8975385edafe343d92dffdhttps://doi.org/10.1302/0301-620x.90b8.20825
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Fixation of intertrochanteric fractures of the femur. A randomised prospective comparison of the gamma nail and the dynamic hip screw1991 · 546 citations
  2. 2Pertrochanteric femoral fractures treated with a dynamic hip screw or a proximal femoral nail2005 · 257 citations
  3. 3Pertrochanteric Fractures: Is There an Advantage to an Intramedullary Nail?2002 · 328 citations
  4. 4Intramedullary nails for extracapsular hip fractures in adults2014 · 180 citations