Table 4 Operative characteristics and radiographic measurements (pre-operative and post-operative), stratified according to the type of nail used

Demographics

 Total number

238

119

119

 Age (years)

73.40 (16.81)

73.02 (16.86)

73.78 (16.82)

 Gender

  Male

84 (35.5%)

42 (35.3%)

42 (35.3%)

  Female

154 (64.7%)

77 (64.7%)

77 (64.7%)

Injury characteristics

 Mechanism of injury

  Low energy

200 (84.0%)

100 (84.0%)

100 (84.0%)

  High energy

4 (1.7%)

2 (1.7%)

2 (1.7%)

  Pathological

34 (14.3%)

17 (14.3%)

17 (14.3%)

 Isolated

205 (86.1%)

103 (86.6%)

102 (85.7%)

 ISS > 16

12 (5.0%)

7 (5.9%)

5 (4.2%)

 Side

  Left

119 (50%)

58 (48.7%)

61 (51.3%)

  Right

119 (50%)

61 (51.3%)

58 (48.7%)

 Open fracture

2 (0.8%)

1 (0.8%)

1 (0.8%)

 Russell–Taylor classification

  1A

68 (28.6%)

29 (24.4%)

39 (32.8%)

  1B

79 (33.2%)

42 (35.3%)

37 (31.1%)

  2A

11 (4.6%)

6 (5.0%)

5 (4.2%)

  2B

80 (33.6%)

42 (35.3%)

38 (31.9%)

Medical comorbidities

 ASA

  1

19 (7.9%)

8 (6.7%)

11 (9.2%)

  2

69 (28.9%)

36 (30.3%)

33 (27.7%)

  3

114 (47.9%)

55 (46.2%)

59 (49.6%)

  4

36 (15.1%)

20 (16.8%)

16 (13.4%)

 Charlson Comorbidity Score

10.12 (4.30)

5.21 (2.80)

4.91 (2.88)

 Diabetes

37 (15.5%)

15 (12.6%)

22 (18.5%)

 Steroids

10 (4.2%)

4 (3.4%)

6 (5.0%)

 Malignancy

50 (21.0%)

29 (24.4%)

21 (17.6%)

 Dementia

39 (16.4%)

22 (18.5%)

17 (14.3%)

Osteoporosis

 Bisphosphonates pre-admission

45 (18.9%)

24 (20.2%)

21 (17.6%)

 Bisphosphonates on discharge

70 (29.4%)

43 (36.4%)

27 (22.7%)

 Calcium/vitamin D pre-admission

73 (30.7%)

35 (29.4%)

38 (31.9%)

 Calcium/vitamin D on discharge

129 (54.2%)

72 (61.0%)

57 (47.9%)

 Vitamin D loading on admission

32 (13.4%)

3 (2.5%)

29 (24.4%)

 Fragility fractures before

49 (20.6%)

17 (14.3%)

32 (26.9%)

 Fragility fractures after

52 (21.8%)

34 (28.6%)

18 (15.1%)

Social history

 Smoking

49 (20.6%)

25 (21.0%)

24 (20.2%)

 Alcohol > 10 units/week

45 (18.9%)

21 (17.6%)

24 (20.2%)

 Pre-operative mobility

  Independent

119 (50.0%)

62 (52.1%)

57 (47.9%)

  Stick(s)/crutch(es)

80 (33.6%)

40 (33.6%)

40 (33.6%)

  Frame

30 (12.6%)

13 (10.9%)

17 (14.3%)

  Wheelchair/hoisted

9 (3.8%)

4 (3.4%)

5 (4.2%)

 Frequent falls

73 (30.7%)

44 (37.0%)

29 (24.4%)

Operation characteristics

 Operation in less than 48 h

187 (78.6%)

79 (66.4%)

108 (90.8%)

 Simultaneous procedures

20 (8.4%)

10 (8.4%)

10 (8.4%)

 Nail diameter (mm)

  9

7 (2.9%)

0 (0.0%)

7 (5.9%)

  11

153 (64.3%)

82 (70.1%)

71 (60.2%)

  13

75 (31.5%)

35 (29.9%)

40 (33.9%)

 Open reduction

117 (49.2%)

59 (49.6%)

58 (48.7%)

 Use of cerclage wires

35 (14.7%)

17 (14.3%)

18 (15.1%)

 Post-op mobilisation (first 6 weeks)

  FWB

114 (47.9%)

52 (43.7%)

62 (52.1%)

  PWB

61 (25.6%)

33 (27.7%)

28 (23.5%)

  TTWB

38 (15.9%)

22 (18.5%)

16 (13.4%)

  NWB

25 (10.5%)

12 (10.1%)

13 (10.9%)

 Surgical time (min)

109.26 (42.94)

104.06 (46.38)

114.51 (38.65)

 Anaesthetic time (min)

49.30 (24.53)

45.78 (28.15)

52.85 (19.72)

 Time from induction to recovery (min)

178.00 (49.82)

171.44 (54.65)

184.63 (43.66)

 Level of first surgeon

  Registrar

150 (63.0%)

72 (60.5%)

78 (66.1%)

  Consultant

87 (36.6%)

47 (39.5%)

40 (33.9%)

 Level of senior surgeon present

  Registrar

140 (58.8%)

68 (57.1%)

72 (61.0%)

  Consultant

97 (40.8%)

51 (42.9%)

46 (39.0%)

Complications

 Re-operation

50 (21.0%)

34 (28.6%)

16 (13.4%)

 Nail failure (any cause)

25 (10.5%)

18 (15.1%)

7 (5.9%)

 Failure at lag screw junction**

18 (7.6%)

11 (9.2%)

7 (5.9%)

 Self-dynamisation

13 (5.5%)

9 (7.6%)

4 (3.4%)

 Cut-out

6 (2.5%)

5 (4.2%)

1 (0.8%)

 Nail infection

2 (0.8%)

1 (0.8%)

1 (0.8%)

 Peri-implant fracture

8 (3.4%)

5 (4.2%)

3 (2.5%)

 Non-union

53 (22.3%)

30 (25.2%)

23 (19.3%)

 HAP/CAP

40 (16.8%)

17 (14.3%)

23 (19.3%)

 UTI

35 (14.7%)

12 (10.1%)

23 (19.3%)

 Wound infection

  Superficial

8 (3.4%)

4 (3.4%)

4 (3.4%)

  Deep

6 (2.5%)

3 (2.5%)

3 (2.5%)

 Washout/revision for Infection

4 (1.7%)

3 (9.1%)

1 (6.2%)

 CKD stage pre-operatively

  Mild

163 (68.5%)

72 (62.6%)

91 (77.1%)

  Moderate/severe

70 (29.4%)

43 (37.4%)

27 (22.9%)

 CKD stage post-operatively

  Mild

170 (71.4%)

84 (74.3%)

86 (73.5%)

  Moderate/severe

60 (25.2%)

29 (25.7%)

31 (26.5%)

 Pre-operative transfusion

16 (6.7%)

11 (9.2%)

5 (4.2%)

 Post-operative transfusion (48 h)

148 (62.2%)

76 (63.9%)

72 (60.5%)

 Hb drop (g/L)

42.83 (17.80)

44.9 (19.09)

40.84 (16.30)

Radiographic measurements

 Femoral neck shaft angle^a

  Normal

159 (66.8%)

80 (67.2%)

79 (66.9%)

  Coxa valga

67 (28.2%)

32 (26.9%)

35 (29.7%)

  Coxa vara

11 (4.6%)

7 (5.9%)

4 (3.4%)

 Number of fragments (comminution)

  Simple

60 (25.2%)

31 (26.1%)

29 (24.4%)

  Moderate

125 (52.5%)

57 (47.9%)

68 (57.1%)

  Severe

53 (22.3%)

31 (26.1%)

22 (18.5%)

 Only subtrochanteric extension

32 (13.4%)

14 (11.8%)

18 (15.1%)

 Atypical

15 (6.3%)

8 (6.7%)

7 (5.9%)

 Pathological

3 (1.3%)

2 (1.7%)

1 (0.8%)

 Distal extension

94 (39.5%)

53 (44.5%)

41 (34.5%)

 Greater trochanter fracture

24 (10.1%)

10 (8.4%)

14 (11.8%)

 Lesser trochanter fracture

163 (68.5%)

80 (67.2%)

83 (69.7%)

 Medial calcar comminution

18 (7.6%)

9 (7.6%)

9 (7.6%)

 Lateral cortex gap size (mm)

   ≤ 4

136 (57.1%)

60 (50.4%)

76 (63.9%)

  5–9

68 (28.6%)

39 (32.8%)

29 (24.4%)

   ≥ 10

34 (14.3%)

20 (16.8%)

14 (11.8%)

 Medial cortex gap size (mm)

   ≤ 4

156 (65.5%)

83 (69.7%)

73 (61.3%)

  5–9

57 (23.9%)

25 (21.0%)

32 (26.9%)

   ≥ 10

25 (10.5%)

11 (9.2%)

14 (11.8%)

 Anterior cortex gap size (mm)

   ≤ 4

156 (65.5%)

82 (68.9%)

74 (62.2%)

  5–9

52 (21.8%)

21 (17.6%)

31 (26.1%)

   ≥ 10

30 (12.6%)

16 (13.4%)

14 (11.8%)

 Posterior cortex gap size (mm)

   ≤ 4

180 (75.6%)

85 (71.4%)

95 (79.8%)

  (5–9)

42 (17.6%)

23 (19.3%)

19 (16.0%)

   ≥ 10

16 (6.7%)

11 (9.2%)

5 (4.2%)

 Reduction angle grouped^b (degrees)

  Valgus 5–varus 5

170 (71.4%)

84 (70.6%)

86 (72.3%)

  Valgus > 5

12 (5.0%)

4 (3.4%)

8 (6.7%)

  Varus 5–10

44 (18.5%)

24 (20.2%)

20 (16.8%)

  Varus > 10

12 (5.0%)

7 (5.9%)

5 (4.2%)

 Anti-rotation screw

74 (31.1%)

0 (0.0%)

74 (62.2%)

 TAD (mm)

   < 25

210 (88.2%)

107 (89.9%)

103 (87.3%)

   ≥ 25

27 (11.3%)

12 (10.1%)

15 (12.7%)

 Distal locking (number of screws)

  1

7 (2.9%)

4 (3.4%)

3 (2.5%)

  2

231 (97.1%)

115 (96.6%)

116 (97.5%)

 Method of locking

  Static locking

155 (65.1%)

72 (60.5%)

83 (69.7%)

  Secondary dynamisation

81 (34.0%)

46 (38.7%)

35 (29.4%)

  Dynamic

2 (0.8%)

1 (0.8%)

1 (0.8%)

 Distance of tip of the nail from centre (AP) (mm)

  − 4 to 4

148 (62.2%)

71 (59.7%)

77 (64.7%)

 Lateral ≥ 5

50 (21.0%)

27 (22.7%)

23 (19.3%)

 Medial ≥ 5

40 (16.8%)

21 (17.6%)

19 (16.0%)

 Distance of tip of the nail from centre (LAT) (mm)

  − 4 to 4

187 (78.6%)

90 (75.6%)

97 (81.5%)

  Anterior ≥ 5

46 (19.3%)

27 (22.7%)

19 (16.0%)

  Posterior ≥ 5

5 (2.1%)

2 (1.7%)

3 (2.5%)

 Distance of tip of the nail from knee (mm)

   < 10

1 (0.4%)

1 (0.8%)

0 (0.0%)

  10 to 19

18 (7.6%)

6 (5.0%)

12 (10.1%)

  20–29

79 (33.2%)

35 (29.4%)

44 (37.0%)

   ≥ 30

140 (58.8%)

77 (64.7%)

63 (52.9%)

 Touching anterior cortex

74 (31.1%)

45 (37.8%)

29 (24.4%)

 Nail/canal ratio

0.82 (0.08)

0.83 (0.08)

0.82 (0.07)

 Hospital stay/mortality

 HDU/ICU stay

25 (10.5%)

10 (8.4%)

15 (12.6%)

 Total length of hospital stay (days)

23.65 (21.29)

23.74 (20.19)

23.56 (22.42)

 Died within a year

14 (5.9%)

10 (8.4%)

4 (3.4%)