Randomized Trial Comparing Hip Arthroplasty and Intramedullary Nail for Unstable Trochanteric Hip Fractures in Older Adults

What this Trial Is About

Researchers are comparing two types of surgeries for patients aged 65 and older who have unstable trochanteric hip fractures, a serious injury common in older adults that often leads to pain, decreased mobility, and increased risk of death. The study aims to see if hip arthroplasty improves mobility, overall health, quality of life, and reduces the need for additional surgeries compared to the traditional intramedullary nail treatment. This trial will help determine the best approach to treat these complex fractures, which currently have high complication and re-operation rates. Participants will be randomly assigned to receive either an intramedullary nail or hip arthroplasty. The intramedullary nail group will have a procedure involving a long nail inserted into the femur and may include additional fixation methods if needed. The hip arthroplasty group will undergo either hemiarthroplasty or total hip arthroplasty using specific prosthetic components, with surgery performed by experienced orthopedic surgeons. Both techniques follow detailed surgical protocols to ensure proper treatment of the unstable fractures. Throughout the study, patients will be followed up at 2, 6, and 12 months after surgery to assess their recovery. Evaluations include patient-reported outcome measures, physical tests such as the timed up and go test and Trendelenburg test, clinical assessments of leg length difference, and hip X-rays to monitor implant positioning and bone healing. The research team will collect data on complications, reoperations, and mortality to compare the effectiveness and safety of each treatment over time.

Intramedullary Nail Versus Hip Arthroplasty in Unstable Trochanteric Hip Fractures