Closed Comminuted Oblique Intertrochanteric Fracture of Neck of Left Femur Clinical Trial
Official title:
Prospective Randomized Trial Comparing the Weight Bearing After Fixation of Proximal Femur Fractures With Two Different Proximal Intramedullary Devices
The purpose of the study is to Compare the stability of the fracture and pain after surgery by measuring the stride length and weight bearing on the operated leg. This study will compare these parameters between two different proximal femur nails used for fixing hip fractures.
Fractures of the proximal femur and hip are relatively common injuries in adults.
According to the Evans and the AO Classification systems, the fracture can be described as
stable after reduction or not according to the direction of the fracture lines and the
comminution of the medial cortex or the lateral wall of the proximal femur.
Biomechanically, nails allow for stable anatomical fixation of more comminuted fractures
without shortening the abductor moment arm or changing the proximal femoral anatomy. These
devices provide fracture stability by virtue of allowing the lateral aspect of the head and
neck to come to rest against the nail in the medullary canal.
For fractures with comminuted medial cortex or involvement of the lateral cortex (AO 2.2 -
AO 3.3) it is advisable to fixate with a more stable fixation device such as intramedullary
proximal femur nail Several intramedullary devices are currently in use for the treatment of
the intertrochanteric fractures. In our institution, for the unstable fracture we use either
one of the intramedullary devices manufactured by Synthes (Proximal femoral nail -
anti-rotation = PFNA) or by Smith&Nephew (Trochanteric Antegrade Nail = InterTan).
Each of these nails allow compression over the Nail\Blade with the intramedullary stability.
There are 3 main complications in the treatment of intramedullary devices : (1) varus
collapse of the head/neck, (2) uncontrolled shortening of the neck, and (3)femoral shaft
fractures at the tip of the nail The InterTan, unlike other devices, allows for immediate
intraoperative compression of the principal fracture fragments through linear compression
combined with rotational stability secondary to its unique geometry and mechanism of action.
The mechanical stability of the fracture after the fixation is reflected by the weight
bearing the patient can hold . In order to find weather there is a mechanical difference
between the two devices we would like to perform a test measuring the weight bearing after
fixation of intertrochanteric fractures comparing the pain and impression of mechanical
stability in the two devices.
The method to test the amount of weight bearing would be using the "SmartStep gait system"
TM (Andante Medical Devices Ltd), an innovative biofeedback and monitoring system that
records and analyzes key gait parameters and provides instantaneous and accurate audio and
visual feedback.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment