Biochemical markers comparison of dynamic hip screw and Gamma nail implants in the treatment of stable intertrochanteric fracture: a prospective study of 60 patients

Abstract

This prospective study compared the extent of surgical trauma following dynamic hip screw (DHS) or Gamma nail (GN) implantation in 60 patients (≥ 60 years old) with stable intertrochanteric fracture. Levels of the biochemical markers creatinine kinase (CK) and C-reactive protein (CRP) were measured pre- and postoperatively. CRP levels were statistically significantly lower on postoperative days 1 and 2 in patients in the DHS versus the GN group; no other differences were observed. Surgical procedures for DHS implantation were considered less invasive than those for GN implantation, although the degree of muscle damage was similar in both groups. The degree of bone and bone marrow damage, rather than muscle tissue damage, may be crucial for determining the CRP response during the operative period. It is concluded that DHS implantation may be described as a more 'systemically' minimally invasive procedure than GN implantation.