Short and long nails exhibited similar treatment failure rates when contemporary cephalomedullary implants were used, according to study results.
Researchers retrospectively reviewed medical records and radiographs from patients who underwent open reduction and internal fixation of intertrochanteric hip fracture with either a short or long cephalomedullary nail between January 2004 and December 2010. Main outcome measures included periprosthetic fracture or reoperation requiring removal or revision of nail, including conversion to arthroplasty.
Among the 559 patients reviewed, the researchers found a treatment failure incidence of 5.4%, of which 5.9% occurred after placement of a short nail compared with 5% after placement of a long nail.
Of the 2% of patients who sustained a periprosthetic fracture after nailing, 2.7% experienced periprosthetic fractures after short nails and 1.5% after long nails.
According to the researchers, major reoperations requiring removal of nail occurred in 3.2% of cases after short nails and 3.5% after long nails. Reasons for revision included screw/helical blade cutout, progressive arthritis with conversation to arthroplasty, avascular necrosis of femoral head with conversion to arthroplasty and symptomatic leg-length discrepancy with conversion to arthroplasty.
Study results showed 25% of patients died within 1 year after index surgery.
Disclosure: The authors have no relevant financial disclosures.