{'fraction_non_alphanumeric': 0.03287671232876712, 'fraction_numerical': 0.010958904109589041, 'mean_word_length': 5.026402640264027, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Short versus Long Cephalomedullary Nails for Pertrochanteric Hip Fractures: A Randomized Prospective Study.

OBJECTIVE
To compare functional and clinical outcomes in patients with pertrochanteric hip fractures treated with either a short (SN) or long (LN) cephalomedullary nail.


DESIGN
Prospective, randomized.


SETTING
Clinical investigation was performed at the Mayo Clinic's Level 1 Trauma Center in Rochester, Minnesota.


PATIENTS/PARTICIPANTS
Two-hundred and twenty patients with intertrochanteric fractures were prospectively randomized to a SN or LN. A total of 168 patients (SN, n=80; LN, n=88) had a mean follow-up of 13.9 months. Fifty-two patients did not meet minimum 3 month follow up. Demographics were comparable between cohorts.


MAIN OUTCOME MEASUREMENTS
The primary outcome measurement was functional outcome evaluated by Short Form (SF-36) and Harris Hip scores (HHS) at 3 months. Secondary outcomes included implant failure, peri-implant fracture, mortality, operative time, estimated blood loss (EBL) and reoperation.


RESULTS
SN and LN cohorts were comparable in all aspects of the SF-36. There was a clinically insignificant difference in the HHS between cohorts. Patients treated in the SN cohort experienced shorter operative times but did not differ in tip-to-apex distance or subtrochanteric fracture extension. There was no difference in implant cut-out, deep surgical site infection or peri-implant fractures.


CONCLUSIONS
Patients treated with SNs or LNs for pertrochanteric femur fractures experienced comparable functional outcomes as measured by SF-36 and HHS. When compared to the LN cohort, SN patients experienced no difference in peri-implant fracture or lag-screw cut-out and tolerated up to 3cm of subtrochanteric fracture line extension.


LEVEL OF EVIDENCE
Therapeutic Level I.