Biologic plating versus intramedullary nailing for comminuted subtrochanteric fractures in young adults: A prospective, randomized study of 66 cases

Po Cheng Lee*, Pang Hsin Hsieh, Shang Won Yu, Chih Wen Shiao, Hsuan Kai Kao, Chi Chuan Wu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

40 Scopus citations

Abstract

Background: Published reports about treatment of comminuted subtrochanteric fractures in young patients are few. This study compared the effectiveness of biologic plating and intramedullary nailing in the treatment of such fractures. Methods: A prospective, randomized, and nonblinded study was conducted. Closed reduction and fracture osteosynthesis were performed with either a dynamic condylar screw (DCS) or a Russell-Taylor reconstruction nail (RTRN) in all 66 patients. The average age of the patients was 36.1 years. The average follow-up period was 28.1 months. Results: All but two patients had uneventful bone union and the average time to union was 15.1 weeks. One implant failure in the RTRN group and one delayed union in the DCS group required additional surgery to achieve bone union. Shorter fluoroscopic time, reduced blood loss, and fewer patients requiring blood transfusion were found in the DCS group, though the DCS group had a higher hip pain score 2 years postoperatively. Otherwise, the surgical results and functional outcomes were comparable between groups. Conclusions: With the enhanced fixation properties demonstrated in the present study, the DCS proved to be a feasible fixation device for comminuted subtrochanteric fractures in young patients. Our results indicated that intramedullary nailing by a RTRN revealed no advantages over biologic plating by a DCS for treatment of such fractures.

Original languageEnglish
Pages (from-to)1283-1291
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume63
Issue number6
DOIs
StatePublished - 12 2007
Externally publishedYes

Keywords

  • Biologic plating
  • Dynamic condylar screw
  • Reconstruction nail
  • Subtrochanteric fractures

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