Short Versus Long Cephalomedullary Nailing for the Treatment of Intertrochanteric Hip Fractures in Patients Over 65 Years Old.

Abstract

Purpose: The purpose of this study is to determine if there is a difference in outcomes between short nails and long nails for the treatment of intertrochanteric hip fractures in patients over 65 years old. Methods: Data on patients 65 years or older who underwent treatment of an intertrochanteric hip fracture with intramedullary nail were collected from a prospectively gathered database from three level I hospitals. Patient medical records, operative reports and digital x-rays were reviewed for outcomes of re-fracture and re-operation. Results: The overall incidence of re-fracture and reoperation was 30 of 559 (5.4%), 13 of 219 short nails (5.9%) vs. 17 of 340 long nails (5.0%) (P = 0.70, chi-square test). There were 11 of 559 (2.0%) patients who sustained a re-fracture, 6 of 219 (2.7%) short nails and 5 of 340 (1.5%) long nails (P=0.35, Fisher’s Exact test). No difference was seen in outcomes between the two treatments. Overall, 175 of 698 patients died less than one year after index surgery for a one-year mortality rate of 25%. Conclusions: Using contemporary implants, short and long cephalomedullary nails have similar outcomes at one-year follow-up.