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Intramedullary Femur Nailing in Intertrochanteric Fractures: Postoperatively Do Helical Blades Migrate More Than Lag Screws? A Randomized Controlled Trial

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Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Objectives

This was a prospective, randomized controlled trial to test functional outcomes between a single lag screw and helical blade nails in the treatment of intertrochanteric fractures.

Methods

72 patients with intertrochanteric fractures between March 2019 to November 2020 were randomized into two groups and treated with a lag screw or a helical blade nail. Intraoperative parameters such as operative time, blood loss, and radiation exposure were calculated. Postoperatively, tip apex distance, neck length, neck-shaft angle, lateral impingement of implant, union rate, and the functional outcomes were measured at the end of 6 month follow-up period.

Results

There was a significant decrease in tip apex distance (p = 0.03) and neck length(p-0.04) with significant lateral impingement of the implant (p = 0.04) in the helical blade group compared to the lag screw group. The functional outcome calculated using the modified Harris Hip score & Parker and Palmer mobility score, at the end of 6 months, had no significant difference between the two groups.

Conclusion

Both lag screw and helical blade devices can be used to successfully treat these fractures, although there is greater medial migration in the helical blade as compared to the lag screw.

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Data availability

Datasets generated or analysed during the current study are available with the computerised data in the Institute of research.

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Funding

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Authors and Affiliations

  1. Department of Orthopaedics, JPN Apex, Trauma Centre, AIIMS, Ansari Nagar, New Delhi, 110029, India

    Arpan Upadhayay, Samarth Mittal & Vivek Trikha

  2. Department of Radiology, JPN Apex, Trauma Centre, AIIMS, Ansari Nagar, New Delhi, 110029, India

    Atin Kumar

Authors
  1. Arpan Upadhayay
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  2. Samarth Mittal
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  3. Atin Kumar
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  4. Vivek Trikha
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Corresponding author

Correspondence to Vivek Trikha.

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Conflict of Interest

The authors have no conflict of interest to declare.

Ethical Clearance

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of AIIMS New Delhi (IECPG-628/19.12.2018, RT-27/23.01.2019). CTRI – The trial was registered on 20th February 2019, and the trial number is CTRI/2019/02/017733.

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Upadhayay, A., Mittal, S., Kumar, A. et al. Intramedullary Femur Nailing in Intertrochanteric Fractures: Postoperatively Do Helical Blades Migrate More Than Lag Screws? A Randomized Controlled Trial. JOIO 57, 1054–1062 (2023). https://doi.org/10.1007/s43465-023-00892-9

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  • DOI: https://doi.org/10.1007/s43465-023-00892-9

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