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Proximal Femoral Nail Antirotation™ (PFNA) Versus Gamma Nail 3™ (Gamma3) for Intramedullary Nailing of Unstable Trochanteric Fractures

Phase 4
Completed
Conditions
Unstable Trochanteric Fractures
Interventions
Device: Gamma Nail 3TM (Gamma3)
Device: Proximal Femoral Nail AntirotationTM (PFNA)
Registration Number
NCT00736684
Lead Sponsor
AO Clinical Investigation and Publishing Documentation
Brief Summary

The purpose of this study is to compare rates of any fracture fixation complication and revision rates after intramedullary fixation of unstable trochanteric fractures between the Proximal Femoral Nail Antirotation™ (PFNA)(Investigational Group) and Gamma Nail 3™ (Gamma3) (Control Group).

Detailed Description

Intramedullary nailing of unstable per- and subtrochanteric femoral fractures is a standard procedure in trauma and orthopaedic surgery. Unstable fractures treated with intramedullary nailing carry the risk of fracture fixation complications. The PFNA (Synthes) has evolved from the original PFN design, featuring a novel antirotation screw. Apart from the prevention of excess rotational forces, this supporting element may enhance the overall stability of the construct, thus potentially reducing fracture fixation complications. Empirical information about the fracture fixation complication rates of the PFNA device is not available. The primary objective of this study is to compare the 1-year fracture fixation rates between the PFNA and Gamma Nail 3™ (Stryker). Secondary objectives of the study are to compare differences in functional outcomes, quality of life outcomes, safety, radiological outcomes, handling and perceived effectiveness between the devices.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
440
Inclusion Criteria
  • Age 55 years and more
  • Patients with isolated, unstable, closed or type 1 open trochanteric fractures, classified as AO 31-A2 or AO 31-A3
  • Definitive primary fracture treatment with PFNA or Gamma3 (defined inTable 1) within three days after the index event
  • Signed written informed consent (by the subjects or legal guardian) and agreement to attend the planned follow-ups
Exclusion Criteria
  • Pathologic fracture of any other cause than osteoporosis
  • Patients or legal guardian refusing to sign the informed consent form
  • Multiple trauma
  • Type 2 and 3 open fractures
  • Drug or alcohol abuse
  • Wound and/or bone healing disorders of any other cause than diabetes mellitus or smoking
  • Active malignancy
  • Expected life expectancy ≤ 3 months
  • Inability to walk independently prior to injury event (use of one stick is allowed. Not meeting inclusion criteria are bedridden, wheel-chair ridden and walker dependent subjects)
  • Neurological and psychiatric disorders that would preclude reliable assessment (eg,, Parkinson disease, Multiple sclerosis, severe depression)
  • Rheumatoid arthritis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2Gamma Nail 3TM (Gamma3)Gamma Nail 3TM (Gamma3)
1Proximal Femoral Nail AntirotationTM (PFNA)Proximal Femoral Nail AntirotationTM (PFNA)
Primary Outcome Measures
NameTimeMethod
Any fracture fixation complication.One year
Secondary Outcome Measures
NameTimeMethod
Bone union/fusion as evaluated by CT-scanning, health-related quality of life, disease-specific functional scoring, activities of daily living, mortality, radiological parameters, surgery details and surgeons' evaluation of handling and effectiveness.One year

Trial Locations

Locations (6)

Hospital Universitario "Marqués de Valdecilla"

🇪🇸

Santander, Cantabria, Spain

Hospital Gregorio Marañon

🇪🇸

Madrid, Spain

Hospital Puerta de Hierro

🇪🇸

Madrid, Spain

Hospital Clinic

🇪🇸

Barcelona, Cataluña, Spain

H.U. Virgen de la Arrixaca

🇪🇸

Murcia, Spain

Hospital Donostia

🇪🇸

San Sebastián, Spain

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