Abstract
Introduction
In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty(BH), compression hip screw(CHS) and proximal femur nail antirotatory(PFNA) in treating comminuted intertrochanteric fractures(AO type, A2(21, 22, 23))
Materials and Methods
We retrospectively evaluated total 150 patients(BH:50, CHS:50, PFNA: 50) who were operated due to intertrochanteric fractures from March 2010 to Dec 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris hip score, ability of ambulation(Koval stage), visual analogue scale and radiologic limb length discrepancy(shortening). Landmark and radiologic length was checked.
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–A: postoperative length
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–A’: POD 1year
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–B: immediate posteopative contralateral length(from hip center to distal tip of lesser trochanter)
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–B’: POD 1year contralateral length(from hip center to distal tip of lesser trochanter)
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Limb length(shortening) was adjusted considering difference of magnification
= {A × (B’/B)}− A’
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Results
There was no statistical significance among three groups in clinical outcomes including Harris hip score, ability of ambulation(Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively.(radiologic shortening- BH: 2.3mm, PFNA: 3.0mm, CHS:5.1mm, p=0.000)
Conclusions
There were no clinical differences among BH, PFNA and CHS in this study. However, notable differences were observed in limb length discrepancy according to selection of operative methods.
