BACKGROUND AND PURPOSE: In recent years, intramedullary nails (INs) for the treatment of pertrochanteric @entity173 have gained prominence relative to conventional, sliding hip screws (SHSs). There is little empirical background for this development, however. A previous series of ours suggested that the use of @entity23734 was not adequate in situations with fragile or fractured lateral femoral walls, where it often led to lack of healing in a maximally telescoped position. We hypothesized that INs would be the superior implant in these specific circumstances. METHODS: We retrospectively examined 311 consecutive @entity1 treated in our department between 2002 and 2008, with either an IN (n = 158) or an @entity23734 (n = 153) mounted on a 4-hole side-plate, for an AO/OTA type 31A1-2 pertrochanteric @entity174 with a detached greater trochanter. The status of the lesser trochanter was assessed preoperatively and the integrity of the lateral femoral wall, @entity174 reduction, and position of the implants were assessed postoperatively. Reoperations due to technical failure were recorded for one year postoperatively. RESULTS: Multivariate logistic regression analysis showed that the groups were similar regarding demographic and biomechanical parameters. The lateral femoral wall was more frequently fractured during @entity23734 implantation (42 @entity1 ) than in the IN group (9 @entity1 ) (p < 0.001). 6 (4%) of the 158 @entity1 operated with IN had to be reoperated, as compared to 22 (14%) in the @entity23734 group of 153 @entity1 (p = 0.001). INTERPRETATION: IN had a lower reoperation rate than @entity23734 in these pertrochanteric @entity173 with a detached greater trochanter. IN left more lateral femoral walls intact.

Intramedullary nailing appears to be superior in pertrochanteric XXXX with a detached greater trochanter: 311 consecutive @entity1 followed for 1 year.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity173 :: ('MESH:D006620', 'Disease') :: ['hip fractures'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fracture'] @entity23734 :: ('MESH:C538400', 'Disease') :: ['SHS']
@entity173 :: (MESH:D006620,Disease) :: ['hip fractures']
