***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We undertook a multicentre , prospect i ve study of a series of 112 unstable trochanteric fractures in order to evaluate if internal fixation with a sliding screw device combined with augmentation using a calcium phosphate degradable cement ( Norian SRS ) could improve the clinical , functional and radiological outcome when compared with fractures treated with a sliding screw device alone .  Pain , activities of daily living , health status ( SF-36 ) , the strength of the hip abductor muscles and radiological outcome were analysed . Six weeks after surgery , the patients in the augmented group had significantly lower global and functional pain scores ( p < 0.003 ) , less pain after walking 50 feet ( p < 0.01 ) , and a better return to the activities of daily living ( p < 0.05 ) . At follow-up at six weeks and six months , those in the augmented group showed a significant improvement compared with the control group in the SF-36 score . No other significant differences were found between the groups . We conclude that augmentation with calcium phosphate cement in unstable trochanteric fractures provides a modest reduction in pain and a slight improvement in the quality of life during the course of healing when compared with conventional fixation with a sliding screw device alone Pertrochanteric fractures are a rising major health-care problem in the elderly and their operative stabilisation techniques are still under discussion . Furthermore , complications like cut-out are reported to be high and implant failure often is associated with poor bone quality . The PFNA ( ® ) with perforated blade offers a possibility for st and ardised cement augmentation using a polymethylmethacrylate ( PMMA ) cement which is injected through the perforated blade to enlarge the load-bearing surface and to diminish the stresses on the trabecular bone . The current prospect i ve multicentre study was undertaken to evaluate the technical performance and the early clinical results of this new device . In nine European clinics , 59 patients ( 45 female , mean age 84.5 years ) suffering from an osteoporotic pertrochanteric fracture ( Arbeitsgemeinschaft für Osteosynthesefragen , AO-31 ) were treated with the augmented PFNA ( ® ) . Primary objectives were assessment of operative and postoperative complications , whereas activities of daily living , pain , mobility and radiologic parameters , such as cement distribution around the blade and the cortical thickness index , were secondary objectives . The mean follow-up time was 4 months where we observed callus healing in all cases . The surgical complication rate was 3.4 % with no complication related to the cement augmentation . More than one-half of the patients reached their prefracture mobility level  within the study period . A mean volume of 4.2ml of cement was injected . We did not find any cut-out , cut through , unexpected blade migration , implant loosening or implant breakage within the study period . Our findings lead us to conclude that the st and ardised cement augmentation using the perforated blade for pertrochanteric fracture fixation enhances the implant anchorage within the head-neck fragment and leads to good functional results A prospect i ve analysis was performed involving 680 geriatric patients with hip fractures to determine whether the demographic profile of patients with femoral neck fractures was similar to that of patients with intertrochanteric fractures . All patients were community dwelling , cognitively intact , previously ambulatory elderly with femoral neck or intertrochanteric fracture . Three hundred fifty-eight patients ( 52.6 % ) sustained a femoral neck fracture ; 322 ( 47.4 % ) , an  intertrochanteric  fracture . Patients with an intertrochanteric fracture were significantly older , more likely to be limited to home ambulation , and were more dependent regarding basic and instrumental activities of daily living . After stratification by gender and adjustment for age , these differences remained significant in women only . There were no differences in age , prefracture ambulatory ability , or dependence in activities of daily living in men with either type of fracture BACKGROUND Despite the good and reliable results of the dynamic hip screw ( DHS ) for stable fracture patterns , complications of excessive sliding of the lag screw and inadequate bone anchorage occur frequently in elderly patients with unstable intertrochanteric fractures . Although polymethylmethacrylate ( PMMA ) bone cement has been widely used as a secondary fixation to facilitate fixation stability , there has been no prospect i ve study on the clinical significance of PMMA cement to prevent these two complications in unstable fracture patterns . METHODS A prospect i ve study was conducted . The DHS was applied either with or without PMMA cement augmentation in 108 elderly patients . The Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association fracture classification was 31-A2 in 91 patients and 31-A3 in 17 patients . The average age of the patients was 81.9 years ( range , 75 - 96 years ) . The average follow-up period was 13.9 months ( range , 12 - 30 months ) . PMMA cement was injected precisely into the proximal fragment with an average amount of 13.7 mL ( range , 10 - 19 mL ) in 55 patients . RESULTS All but six patients ( 5.6 % ) had eventual bone union , and the average time to union was 18.1 week ( range , 12 - 36 weeks ) . Screw sliding , femoral shortening , and varus collapse of the proximal fragment were all significantly reduced in the cemented group at the 1-year follow-up ( p < 0.001 , p < 0.001 , p < 0.001 , respectively ) . The mean hip pain score was 1.9 ( range , 1 - 4 ) in all 102 patients and was significantly lower in the cemented group ( p = 0.008 ) . One patient with a deep infection in the cemented group and five patients with lag screw penetration in the noncemented group received a total hip replacement . All 18 patients with malunion were in the noncemented group . Of these 18 patients , 14 patients ( 77.8 % ) had excessive sliding of the lag screw . The overall complication rate was significantly higher in the noncemented group ( p < 0.001 ) . CONCLUSIONS With the meticulous augmentation technique demonstrated in this study , the PMMA cemented DHS proved to have better outcome than a conventional DHS for unstable intertrochanteric fractures in elderly patients . Typical complications related to a conventional DHS device for the treatment of such fractures were successfully prevented 
    Output:
    
However , radiographic parameters ( mean lag screw sliding distance and varus deformity ) were better in the augmentation group .