Locked Plating Versus Cephalomedullary Nailing of Unstable Intertrochanteric Femur Fracture

Intertrochanteric fractures of femur are common in elderly. Intramedullary nailing is becoming more popular, particularly in unstable fractures. Although, intramedullary devices are technically difficult, they seem to have a biomechanical advantage over proximally fixed side plates. we aimed to analyze results of cephalomedullary nailing & locked plating for treatment of unstable intertrochanteric femur fractures. This randomized controlled clinical trial was conducted on twenty patients with unstable intertrochanteric fractures that were treated with cephalomedullary nail and locked plate, at orthopedic surgery department at Al-Zahraa University Hospital for girls, Faculty of Medicine, Al-Azhar University Egypt from December 2019 to December 2021. The patients were randomly divided into two groups: Group I: received cephalomedullary nail treatment, group II: received proximal femur anatomical locked plate treatment. 20% and 40% of patients in group I, II respectively had developed complications, 10% of patients had infection with mechanical failure in group I & 20% of patients had infection in group II. Also in group II, reoperation, mechanical failure, and nonunion were higher than that in group I. Cephalomedullary nail is superior to proximal femur anatomical locked plate in treatment of unstable intertrochantric fracture of femeur as regard post-operative complications, mechanical failure, malunion, nonunion and reoperation.