Abstract: Background: There are two methods to treat intertrochanteric fracture: conservative or operative way. The internal fixations are usually considered as prior options for treatments that can enable the patient to have postoperative early mobilization, good functional recovery and fewer complications. With the time of invention and advances of internal fixation devices, the diversity of devices brings orthopedic surgeons more choices, such as intramedullary fixation (e.g. gamma nail) or extra medullary fixation e.g. dynamic hip screw (DHS). The aim of this study was to compare the short-term outcomes after gamma nail and DHS fixation of stable intertrochanteric fractures, concentrating especially on the functional aspects.
Methods: This prospective randomised trial was done on 34 patients with stable intertrochanteric fracture in skeletally mature patients (recent closed) within two weeks. Patients were divided into two groups: Group I had 17 cases which were treated by DHS and group II had 17 cases which treated by gamma nail. Randomization was done by systematic random sampling technique of patients, all patients were operated within the first 2 weeks of injury.
Results: In both groups, patients below 65 years show better functional results than those above 65 years, but these results were statistically insignificant where (p= 0.255) for group I and group II (p = 1.000). No statistically significant difference was observed regarding gender, and duration before operation. Group I and Group II both exhibited no statistically significant correlation between functional outcomes and medical comorbidities, and smoking. There was a significant relation between medical comorbidities and time of union in both groups I and II where (P = 0.007). Results were statistically significant in-group I between smoking and time of union where (p = 0.014) for group I, but insignificant in-group II where (P =0.648.
Conclusions: The functional and radiological outcomes of both the gamma III nail and DHS procedures were positive. Both techniques are comparable without significant merits of one technique over the other one. The study has three significance results: More blood loss in DHS group. Medical comorbidities affect time of union. Smoking affects functional results in DHS group.
