Long versus short cephalomedullary femoral nail for treatment of unstable intertrochanteric fractures: A single-blinded randomized controlled study

Abstract

Background: ITF are extracapsular proximal femoral fractures that occur in both younger and older populations, with a higher prevalence among females. They account for most hip fractures, reaching 44.1%. The Elderly are at risk with an increased first-year mortality risk reaching up to 30%. This research aimed to compare the functional outcomes, effectiveness, and safety profile of long as opposed to short cephalomedullary nails (CMNs) in the management of unstable ITF in elderly individuals aged >60 years. Methods: This single-blinded randomized controlled research was carried out on 30 participants aged >60 years old, both sexes, with unstable ITF. Participants were categorized into two groups (GPs): GP A: had a long cephalomedullary nail (LCMN), and GP B: had short cephalomedullary nail. Results: Mean hospital stay length, period of surgery, operative blood loss, and the incidence of transfusion requirements were higher in GP A, yet no significant difference was observed. Functional outcomes, union and complication rates were comparable between the two GPs. Conclusions: Irrespective of the length, CMNs are suitable for the treatment of unstable ITF, aiming to achieve early mobility and satisfactory functional outcome. Further large-sampled RCTs need to be conducted comparing both GPs based on more recent CT-based classification systems with osteoporosis considered.