Comparison of the functional outcome of extramedullary and intramedullary fixation for unstable intertrochanteric femoral fractures

Abstract

 The purpose of this study was to compare the functional outcome of patients undergoing extramedullary and intramedullary fixation types for unstable intertrochanteric fractures of the femur. Methods: 52 cases of unstable intertrochanteric femoral fractures (AO/OTA 31A2.2-31A3.30) were treated in between 1st January 2016 to 31st December 2017 at the Department of Orthopaedic Surgery, Chittagong Medical College Hospital. Patients were divided into two groups by consecutive sampling. Group A underwent intramedullary fixation while group B underwent extramedullary fixation. Patients were evaluated clinically and radiologically for outcome. All patients were followed up for an average of 24 weeks. Outcome was assessed using the Lower Extremity Measure (LEM) Score. Result: In this study, 52 cases of unstable intertrochanteric fractures were divided into two groups and treated. In the study, 27 patients were male and 25 were female. In the intramedullary group, 07(27%) were from younger age group and 19(73%) were in the older age group. In the extramedullary group 06(23%) were from the younger age group while 20(77%) were from the older age group. In the study, 27 (52%) fractures united within 10-12 weeks and there was no significant difference amongst the two groups. There was no significant difference in the overall functional outcome amongst the two groups (p=0.552) at four months.  Conclusion: In this study, there was no significant difference in the functional outcome of patients with unstable intertrochanteric fractures treated with intramedullary or extramedullary fixation although large, multicentre and longer duration studies can be undertaken to evaluate this further.