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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Objectives To compare the clinical and radiological outcomes between gamma nail and dynamic hip screw (DHS) in the treatment of intertrochanteric hip fractures in Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification subgroup 31-A1.3. Background In recent years, intertrochanteric fractures have become more prevalent, with a death rate of 30% within 5 years of the fracture. Trauma with high energy (rare; found in young male patients) or simple falls with low energy can cause intertrochanteric hip fractures (common; seen in elderly female patients). Patients and methods A prospective study was carried on 34 patients with intertrochanteric hip fractures, AO classification subgroup 31-A1.3, who were operated on using DHS or gamma nail, with 17 cases managed by DHS (group I) and 17 cases managed by gamma nail (group II). Inclusion criteria were skeletally mature (adult) and intertrochanteric fracture of the hip, AO subgroup 31-A1.3. Results In terms of functional grading, group I had 14 satisfactory outcomes and only three unsatisfactory results, whereas group II had 15 satisfactory results and only two unsatisfactory results; nevertheless, there were statistically insignificant differences in anatomical grading. For groups I and II, the percentage of patients who needed fewer than 12 weeks for union was 76.5 and 82.3%, respectively, and the mean time was 10 ± 2 and 9 ± 2 weeks, respectively. The union time discrepancies were not statistically significant. Conclusion Both gamma III nail and DHS techniques had satisfactory outcomes, namely, functional and anatomical. In addition, age, sex, medical history, and fracture classification had no influence on the outcome, may be because of the stable pattern of fracture enrolled in our study.

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