Treatment of Intertrochanteric Fracture with Dynamic Hip Screw and Gamma Nail: A Retrospective Matched Pair Study

Kang, Joon Soon; Park, Seung Rim; Kim, Hyung Soo; Lee, Woo Hyeong; Kim, Ki Wook; Lee, Jun Hee

Abstract

PURPOSE
To compare the clinical and radiological results obtained using dynamic hip screws and Gamma nails for the treatment of intertrochanteric fracture of the femur.
MATERIALS AND METHODS
We performed a retrospective study of 45 pairs of dynamic hip screw (DHS) and Gamma nail (GN) patients which were matched for sex, fracture type, and Singh index for the treatment of intertrochanteric fracture (matched pair control study). Mean duration of follow-up was 34.5 months (range, 12-62 months).
RESULTS
No significant differences were found in terms of operation time, amount of transfusion, neck-shaft angle, sliding of the lag screw, union time, and mechanical complications between the two groups in the cases of stable fractures. For unstable fractures, the operation time of the DHS group was 144.7+/-40.7 minutes and that of GN group was 92.0+/-50.7 minutes (p<0.05) respectively. Mean blood transfusion units of the DHS group were 1.6 pints and of the GN group were 1.1 pints (p<0.05). No statistical differences were found between the two groups in terms of the mean duration of union, the sliding of lag screw or change of neck shaft angle in unstable fractures. Moreover there was no statistical difference between the two groups in terms of mechanical failure according to the Singh index and type of fracture.
CONCLUSION
No significant differences were found between the two devices in the treatment of stable fractures. In unstable intertrochanteric fractures, Gamma nail was more useful device but only for in terms of reducing the operative time and blood loss and not in relation to union, fixibility and sliding.