Clinical and radiological outcomes of trochanteric fractures: Comparison between TWO different intramedullary nails

Two types of cephalic implants are the main choices for fixing trochanteric fractures. First implant is historically widely used screw, and the second one is more recently designed helical blade. The notabel difference of helical blades is, they avoid bone loss while drilling and inserting the implant and they obtain a high stability and causes less complications. Although there are much biomechanical studies, clinical studies are not sufficient in literature. The main purpose of our study is to compare the clinical and radiological outcomes of AO/OTA Type 31A2 fractures treated by the use of trochanteric nails either with blade or screw. Our study is designed retrospectively. Between May 20007 and May 2014, a total of 144 patients with trochanteric fractures are addmitted to our clinic, and only 65 of them met the inclusion criterias. 32 of them (Group 1) were treated with helical blade and the rest 33 (Group 2) were treated with screw. Mean age of them were 76,01 and 75,82 respectively. Between these two groups, we investigated the differences in TAD, cephalic implant positions, union rates, cut-out rates and implant failures. Mean follow-up time was 2,30 years. No significant differences were seen between two groups by the mean of cutting-out, non-unions, cephalic implant positions and varus collapse. Cutting out was seen in total of 6 patients (Blade n=2, Screw=4), non-union in 9 patients (Blade n=5, Screw n=4); varus collapse in 9 patients (Blade n=5, screw n=4). Harris Hip Scores were similar between two groups In AO/OTA type 31A2 fractures, both the screw or blade can be chosen, the main factor that influence on outcomes is the quality of reduction and positioning of the implant.