Functional outcome of ipsilateral intertrochanteric and femoral shaft fractures.

Abstract

The purpose of this study was to compare the functional outcome of patients with ipsilateral intertrochanteric and femoral shaft fractures treated with a reconstruction nail versus a sliding hip screw and retrograde nail. Retrospective cohort study. Two level 1 trauma centers. Twenty-six patients with ipsilateral intertrochanteric and femoral shaft fractures treated between 1993 and 2003 with a reconstruction nail (n=13) or with a sliding hip screw and retrograde nail (n=13). Internal fixation with a reconstruction nail or a sliding hip screw and retrograde nail. Functional outcome was measured using the Short Form-36 (SF-36), Short Musculoskeletal Functional Assessment (SMFA), and Lower Extremity Functional Scale (LEFS). The average time to follow-up was 49.6 months. Functional outcome was significantly better in the sliding hip screw with retrograde nail group for the role emotional (P=0.001) and mental component scores (P=0.016) of the SF-36. This group also scored better on the LEFS, although not reaching statistical significance (P=0.099). For most outcome measures, no significant differences in functional outcome scores were observed between the 2 treatment groups. The results of this study suggest the need for a randomized controlled trial with a larger sample size to more definitively compare the 2 fixation constructs.