AAOS2017: Unlocked femoral nails safe and effective in stable intertrochanteric fractures

Study Type: Randomized Trial
OE Level of Evidence: N/A
Journal Level of Evidence: N/A
This ACE Report is a summary of a conference presentation or abstract. The information provided has limited the ability to provide an accurate assessment of the risk of bias or the overall quality. Please interpret the results with caution as trials may be in progress and select results may have been presented.
240 patients undergoing intramedullary nail fixation of stable intertrochanteric femoral fractures were randomized to three groups; static locking, dynamic locking, or no locking. Patients were assessed for intraoperative outcomes, and clinical outcome measure over 12-month follow-up. Patients in the Please login to view the rest of this report. Please login to view the rest of this report.
Why was this study needed now?
Few clinical trials have provided an evaluation of the effectiveness of distal locking nails in the management of stable intertrochanteric femoral fractures compared to unlocked nails.
What was the principal research question?
In intramedullary nail fixation of stable intertrochanteric femoral fracture, are there significant differences in intraoperative and clinical outcomes between nails that are unlocked, static locked, or dynamically locked?
Population: 240 patients, over the age of 65 years, with a stable intertrochanteric fracture (AO/OTA 31-A1). All patients included in this trial underwent fixation using the same type of intramedullary nail.
Intervention: Dynamic group: patients received dynamic distal locking (n=80) Static group: patients received static distal locking (n=80)
Comparison: Unlocking group: patients did not receive a distal lock (n=80)
Outcomes: Outcomes included operation time, the volume of blood loss, total fluoroscopy time, the total length of incision, the Short-Form 12-Item Health Survey, and the Barthel Index.
Methods: RCT: Multicenter
Time: Clinical and radiographic follow-ups were conducted at 1, 3, 6, and 12 months postoperatively.
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.