Comparison of Intramedullary and Extramedullary Fixation of Basicervical Fractures of the Femur in the Elderly: A Prospective Randomized Study

Aim:Basicervical fractures of the femur are a unique type of unstable hip fracture, usually treated with sliding hip screw (SHS) or cephalomedullary nail (CMN). The aim of this randomized, prospective study was to evaluate the outcomes and complications of the two different treatment methods, SHS and CMN, in the management of basicervical fractures of the femur in the elderly osteoporotic bones.Methods:Patients aged over 65 years, who presented to our clinic with basicervical fracture of the femur between January 2016 and January 2018, were included in the study. The permuted block randomization method was used to randomize the participants into groups. The patients were allocated to one of two groups treated via CMN (n=29) or SHS (n=27). Functional and radiological evaluations included mobility score, Harris Hip score, modified Barthel index, Singh index, tip-apex distance, and fracture settling.Results:Continuous improvement in the Barthel index was seen over the 12-month period in either group (p<0.05). The average mobility score was found to be decreased at the 6th week follow-up visits in either group (p<0.05). The fracture settling measurements in SHS group was higher than in CMN group (p<0.01).Conclusion:The clinical and radiological outcomes of both CMN and SHS groups showed no superiority of one technique over the other in the treatment of basicervical fractures of the femur.