• Sinan Zehir, R Zehir, Sultan Zehir, İ Azboy, and N Haykir.
• Hitit University Research and Training Hospital Orthopedic and Traumatology Clinic, 19100 Merkez, Corum, Turkey, sinanzehir@yahoo.com.
• Eur J Trauma Emerg Surg. 2015 Aug 1; 41 (4): 393-400.

AimWe sought to determine whether intramedullary fixation with proximal femoral nail antirotation produces comparable outcomes to dynamic hip screw in the treatment of unstable trochanteric fractures.Materials And MethodsPatients were randomly allocated to receive proximal femoral nail antirotation (Group 1, n = 96, mean age; 77.22 ± 6.82 years) or dynamic hip screw (Group 2, n = 102, mean age; 76.86 ± 6.74 years). Outcome measures were time of operation and fluoroscopy, amount of blood loss and occurrence of surgery-related complications. Tip-apex distance and femoral neck shortening were also evaluated. Patients were evaluated at the sixth month to assess the recovery of walking ability. Survival information was obtained from a civil registry.ResultsOperative and fluoroscopy times were significantly shorter and blood loss was significantly lower in Group 1 than those in Group 2. Complication rates, mean tip-apex indices and recovery of walking ability were similar between groups, whereas independent walking was more common in Group 1 than in Group 2. Until the sixth month, screw cutout occurred in eight (7.8%) and seven (7.3%) patients in Group 1 and Group 2, respectively (p = 0.88). Three-year survival rate was 61.6 ± 9.4 vs 57.3 ± 9.7 % in Group 1 and Group 2, respectively (p = 0.50).ConclusionProximal femoral nail antirotation technique offers better recovery than dynamic hip screw, whereas both techniques possess the same risk of postoperative complications.

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