Intramedullary Femur Nailing in Intertrochanteric Fractures: Postoperatively Do Helical Blades Migrate More Than Lag Screws? A Randomized Controlled Trial.

OBJECTIVES: This was a prospective, randomized controlled trial to test functional outcomes between a single lag screw and helical blade nails in the treatment of intertrochanteric fractures.

METHODS: 72 patients with intertrochanteric fractures between March 2019 to November 2020 were randomized into two groups and treated with a lag screw or a helical blade nail. Intraoperative parameters such as operative time, blood loss, and radiation exposure were calculated. Postoperatively, tip apex distance, neck length, neck-shaft angle, lateral impingement of implant, union rate, and the functional outcomes were measured at the end of 6 month follow-up period.

RESULTS: There was a significant decrease in tip apex distance ( p  = 0.03) and neck length(p-0.04) with significant lateral impingement of the implant ( p  = 0.04) in the helical blade group compared to the lag screw group. The functional outcome calculated using the modified Harris Hip score & Parker and Palmer mobility score, at the end of 6 months, had no significant difference between the two groups.

CONCLUSION: Both lag screw and helical blade devices can be used to successfully treat these fractures, although there is greater medial migration in the helical blade as compared to the lag screw.