• Eur J Orthop Surg Tr · Jul 2015

    Comparative Study

    Nailing or plating for subtrochanteric femoral fractures: a non-randomized comparative study.

    • Ahmet Imerci, Umut Canbek, Vasfi Karatosun, Levent Karapınar, and Murat Yeşil.
    • Department of Orthopaedics and Traumatology, Faculty of Medicine, Mugla Sıtkı Kocman University, Muğla, Turkey, ahmet_dr81@hotmail.com.
    • Eur J Orthop Surg Tr. 2015 Jul 1; 25 (5): 889-94.

    BackgroundThe aim of the present study was to compare the outcomes of reverse less invasive stabilization system for distal femur (LISS-DF) plates and proximal femoral nail antirotation (PFNA) in the treatment of patients with subtrochanteric fracture.MethodsThirty-one patients with 32 fractures were included in this study. The PFNA group consisted of 16 patients, and the reverse LISS-DF plate group consisted of 15 patients. Intraoperative data such as surgical time (min), amount of blood transfusion (units and erythrocyte suspensions) and radiation time (seconds) were noted. Time elapsed until fracture consolidation (weeks), time until full weight bearing (weeks), mean Harris hip score and length of stay (LOS) at hospital (days) were recorded postoperatively.ResultsThe reverse LISS-DF group had a significantly longer elapsed time until fracture consolidation (p < 0.05). The mean radiation time was significantly longer (p < 0.05), and the Harris hip scores at last control were significantly higher (p < 0.05) compared with the PFNA group. No significant differences were determined in terms of complications and re-operation rates.ConclusionThis study demonstrated that in the reverse LISS-DF-treated group, the mean time for bone union was longer and weight bearing was delayed. Considering the surgical technique, minimal surgical approach, reduced amount of blood transfusion and superior functional results following surgery, we concluded that the PFNA system offers advantages over reverse LISS-DF plating in the treatment of subtrochanteric femur fractures.

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