Objective: The purpose of this study was to compare failure rates between short and long intramedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age.
Methods: A retrospective review of 156 patients aged more than 65 years with femoral intertrochanteric fractures from December 2010 to December 2012 was performed. The patients were allocated to two groups: those treated with long nail (n=59) and short nail (n=97). Relevant patient variables and medical comorbidities were collected. Medical comorbidities were evaluated according to the American Society of Anesthesiologists classification and medical records were also reviewed for age, sex, intraoperative blood loss, operative time, length of stay, time to fracture union, hip pain, Harris Hip Score 1 year postoperatively, and failure rates. The failure rate was defined as periprosthetic fracture or reoperation requiring removal or revision of nail. Variables were statistically compared between the two groups, with statistical significance at P<0.05.
Results: Patients treat with long nails and short nails were comparable for all assessed clinical variables (P>0.05). There were no statistically significant differences between these groups in intraoperative blood loss, time to fracture union and Harris Hip Score at 1 year postoperatively (P>0.05). The long nail group had significantly less failure rate (0/59) and hip pain rate (3/59) than those with short nail (3/97 and 13/97, respectively) (P < 0.05), but the operative time was significantly longer in the former (60.60 ± 11.43 minutes) than the latter (53.10 ± 8.51 minutes) group (P < 0.05).
Conclusions: Both the long and short intramedullary nails are the optional internal fixation choices for femoral intertrochanteric fracture in the aged patients older than 65 years. But the long nail could avoid the refracture of femur and reduced postoperative hip pain.
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