Senior Thesis
Abstract
Short versus long cephalomedullary nails for the treatment of intertrochanteric hip fractures in patients over 65 years old
Background
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%.
Conclusion
Spinal epidural abscesses have high risk for faiUsing contemporary implants, short and long cephalomedullary nails have similar outcomes at one-year follow-up.