The trochanteric gamma nail versus the dynamic hip screw:: a prospective randomised study.: One-year follow-up of 146 intertrochanteric fractures

In a prospective, randomized trial we compared the trochanteric gamma nail (TGN) and the dynamic hip screw (DHS) in the treatment of 146 intertrochanteric fractures. Follow-up was after four and 12 months. The operation time was significantly shorter in the DHS group. At discharge the need for walking aids was less in the DHS group. There were no differences in intraoperative blood loss, medical complications, mortality or length of hospital stay. Major fracture complications occurred twice as often in the TGN group compared with the DHS group, however they were not statistically significant. Any potential for the TGN leading to a less invasive procedure and a more rapid postoperative mobilisation could not be demonstrated. Compared with the TGN we prefer the DHS for most intertrochanteric fractures in a setting where the majority of these fractures are treated by younger doctors and not by highly specialized hip/trauma surgeons. The TGN may have advantages in selected intertrochanteric fractures.