Comparative study of gamma nail versus dynamic hip screw in fixation of unstable peri-trochanteric fractures regarding operative outcomes

Background
Hip fractures are considered one of the major health problems in aging societies. These fractures are correlated with increased disability and mortality and a decreased quality of life.


Objective
To compare the operative outcomes of Gamma nail versus dynamic hip screw in fixation of unstable peri-trochanteric fractures.


Methods
This is an open labelled Randomized controlled clinical trial conducted on patients presented to orthopedic department with unstable peri- trochanteric fracture between June 2020 and December 2021. 60 patients included in this study. The patients were randomized into two groups each group contains 30 patients, Group A (patients with peri-trochanteric fractures treated with DHS) and Group B (patients with peri-trochanteric fractures treated with Gamma nail).


Results
The difference between Gamma group and DHS group regarding Parker mobility score was highly statistically significant after 1.5 MD [95% CI]−0.49 [−0.78–−0.21] P value <0.01 and very highly statistically significant after 3 MD [95% CI]−0.78 [−1.06–−0.48], P value <0.001, while there was no statistically significant difference after 6 and 12 months. The Gamma group does not statistically significant differ from DHS group regarding time to union MD [95% CI] 0.23 [−0.16–0.63] months, P value >0.05.


Conclusion
This study shows that Gamma nail is a safe and reliable modality in the management of peri-trochanteric fractures. It has lesser operative time, and lesser blood loss and comparable results regarding the time to union and hospital study.