Comparing Cephalomedullary Nailing and Dynamic Hip Screw Methods Among type A2 Intertrochanteric Fractures

Background and objectives: intertrochanteric fracture is a prevalent condition among the elderlythat affects many people annually in both health and financial status. type a2 intertrochantericfracture is treated with surgical internal fixation either through a cephalomedullary nail (cmn)or a dynamic hip screw (dhs). this study compares radiological and clinical outcomes of cmnand dhs devices in patients with type a2 intertrochanteric fractures.methods: in this retrospective cohort study, hospitalized patients with a2 intertrochantericfracture who were treated with either cmn or dhs devices from 2014 to 2023 were includedin the study. all participants were assessed retrospectively regarding radiological outcomes(nonunion, varus malunion, and femoral medialization percentage) clinical outcomes, andincidence of pulmonary thromboembolism and deep vein thrombosis.results: a total number of 194 patients were included in the study. the patients who were operatedon with dhs showed a better result regarding the incidence of varus malunion compared tocmn (p=0.009), while the incidence of nonunion and union failure, and percentage of femoralmedialization showed no significant difference between groups. despite a comparable total scoreof modified harris hip score in both groups (p=0.669), dhs surgery had a better outcome in thewalking distance status component (p=0.043).conclusion: despite better outcomes of dhs surgery regarding the incidence of varus malunionand walking distance status, other outcomes of both groups did not show a significant difference.however, more prospective studies with multiple systematic follow-ups and radiographs areneeded to confirm these findings.