Functional outcomes after intertrochanteric hip fractures improved with antegrade nail device

SAN DIEGO — Treatment of intertrochanteric hip fractures in elderly patients with an intertrochanteric antegrade nail was associated with better functional capacity than with a sliding hip screw, according to a presenter here.

“Overall, taking all-comers, there was no difference in adverse events, locomotor function or functional outcome in recovery,” David Sanders, MD, said at the Orthopaedic Trauma Association Annual Meeting. “There was less radiographic shortening in the InterTAN (Smith & Nephew) group compared to the sliding hip screw.”

Among patients who were high functioning, meaning they could walk independently, “there was more rapid return to function, better radiographic results and better physical function scores using the InterTAN device compared to the sliding hip screw,” he said.

David Sanders

In this multicenter randomized controlled trial, Sanders and colleagues randomly assigned 250 patients with intertrochanteric hip fractures who were aged 55 years or older for treatment with the InterTAN device or a sliding hip screw. Primary outcome measures used were the Functional Independence Measure (FIM) and the Timed Up and Go (TUG) test.

Sanders noted there were minimal differences between the sliding hip screw and InterTAN device results.

“FIM score at all time periods was essentially the same,” he said. “The Timed Up and Go results were similar.”

Radiographic outcomes showed the sliding hip screw group more commonly experienced partial union and shortening that sometimes exceeded 2 cm. – by Casey Tingle

Reference:

Sanders D, et al. Paper #33. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 7-10, 2015; San Diego.

Disclosure: Sanders reports he is a paid consultant for and received research support from Smith & Nephew Richards, he received financial and material support from the Journal of Orthopaedic Trauma and is a board member for the Orthopaedic Trauma Association.