Functional outcome in treatment of unstable trochanteric and subtrochanteric fractures with the proximal femoral nail and the Medoff sliding plate
2007 (English)In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 21, no 1, 18-25 p.Article in journal (Refereed) Published
Objective: To compare outcome between the proximal femoral nail (PFN) and the Medoff sliding plate (MSP) in patients with unstable trochanteric or subtrochanteric fractures.
Methods: This was a consecutive prospective randomized clinical study. In all, 203 patients admitted to two university hospitals with an unstable trochanteric or a subtrochanteric fracture type were included. Surgery was performed with a short intramedullary nail or a dual-sliding plate device. Follow up visits occurred at 6 weeks, 4 months, and 12 months. Functional outcome was measured by walking ability, rising from a chair, curb test, and additional assessments of abductor strength, pain, living conditions, and complications.
Results: The ability to walk 15 m at 6 weeks was significantly better in the PFN group compared to the MSP group with an odds ratio 2.2 (P = 0.04, 95% confidence limits 1.03-4.67). No statistical difference in walking ability could be found between trochanteric and subtrochanteric fractures. The major complication rate (8% in the PFN group and 4% in the MSP group) did not differ statistically (P = 0.50) but reoperations were more frequent in the PFN group (9%) compared to the MSP group (1%; P < 0.02).
Conclusions: There were no major differences in functional outcome or major complications between the treatment groups. Reasons other than the operated fracture seem to be equally important in determining the long-term functional ability of the patients in our study. An advantage with the MSP was the lower reoperation rate.
Place, publisher, year, edition, pages
2007. Vol. 21, no 1, 18-25 p.
Aged, Aged; 80 and over, Bone Nails, Bone Plates, Equipment Design, Equipment Failure Analysis, Female, Femoral Fractures/complications/diagnosis/*surgery, Fracture Fixation; Internal/*instrumentation/methods, Gait, Humans, Joint Instability/diagnosis/etiology/*prevention & control, Male, Middle Aged, Recovery of Function, Treatment Outcome
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-14800DOI: 10.1097/BOT.0b013e31802b41cfISI: 000243606400004PubMedID: 17211264OAI: oai:DiVA.org:uu-14800DiVA: diva2:42571