Comparison of Second and Third-Generation Nails in the Treatment of Intertrochanteric Fracture: Screws versus Helical Blades.

ABSTRACT

OBJECTIVE: The aim of this study was to compare the radiological and functional outcomes of anti-rotation trochanteric nails (ATNs) with proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric femur fractures in elderly patients. MATERIALS AND METHODS: In total, 165 intertrochanteric fractures were treated between January 2007 and January 2010. One hundred forty patients were included. The operation time, amount of blood loss, fluoroscopy screening time, and length of hospitalization were recorded. The radiological position of the implant, quality of fracture reduction, and tip-apex distance were evaluated, and the postoperative complications as well as functional condition of the patients were assessed. RESULTS: There were no significant differences between the ATN and PFNA groups for the presence of general complications, length of hospitalization, and functional capacity. The mean operation time, blood loss amount, and fluoroscopy screening time were more in the ATN group than in the PFNA group. Reoperation was needed for nine and two patients in the ATN and PFNA groups, respectively, because of implant-related complications. CONCLUSION: Both ATNs and PFNA were suitable for the fixation of intertrochanteric fractures, but the risk of complication occurrence and need for reoperation were found to be higher in patients who were treated with ATNs.