Analysis of Six Hundred and Twenty-two Intertrochanteric Hip FracturesJ Bone Joint Surg Am; 61 (2): 216 – 221.
11 January 2011 (online)
The results of a case series conducted from 1970 to 1975 in which 268 patients with intertrochanteric fractures treated with intramedullary (IM) nailing using primarily Massie nails (90%) were compared to a retrospective group of 354 patients treated from 1959 to 1969 for the same fracture type using IM fixation with various other devices (Massie nail: 59%; other 41%). Better overall results (combined range of motion, walking ability, and pain) and lower mortality, as well as a decreased hospital stay were seen in the more recent study as compared to the historical series. Device failure and complication rates were similar between the two groups. Improved overall medical care, more experience with the surgical method, interfragmentary fixation with the use of a telescoping nail (Massie nail), and early ambulation were believed to be the main factors responsible for the improvement. Type IV unstable fractures remained a problem with continued high rates of nonunion across the combined series.