Materials and methods
fracture, subtrochanteric fractures, death, trauma
PATHOLOGICAL FRACTURES, GROUP B
All patients with a peri-trochanteric fracture treated from January 2017 until December 2019, in the same level 2 trauma centre were prospectively included in the study. Patients with fracture patterns feasible to treatment with a short proximal femoral nail were included in the study and randomly assigned into two study groups. The randomisation was conducted by using a computer generated algorithm at the time of admission. Patients in Group A were treated operatively using a short proximal femoral nail (KFN, Königsee Implantate GmbH, Germany) with one lag screw, and patients in Group B were treated using the same nail and the addition of the second anti-rotational lag screw. Patients with subtrochanteric fractures, requiring long nailing or pathological fractures were excluded from the study. The patients who had less than three months follow-up due to death or other reasons were also excluded from the study. The patients were followed up until radiological and clinical union, for at least three months.Preoperative demographic, injury and medical history data were collected. The mental status of the patients was evaluated with the abbreviated mental score [Radiographic measurements obtained from the follow-up radiographs. The diameter of the neck was measured at the point where the roundness of the head ends of the head and the distance of the lag screw from the lower border of the neck and the distance of the anti-rotational nail from the upper border of the neck, for these distances the letter Ω due to its shape, Ω: the diameter of the neck, Ω1: the distance of the lag screw from the lower border of the neck and Ω2: the distance of the anti-rotation nail from the upper border of the neck. The posterior slippage of the lag screw in the first postoperative months was measured as the distance of the lag screw from the lower border of the neck and the TAD give us the position of the nail, i.e. how low and how deep it is located, and the angle X informs about its direction