***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 
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    Input: One hundred thirty-one patients ( 135 fractures ) who sustained an intertrochanteric fracture were assigned r and omly to treatment with either a sliding hip screw or an intramedullary hip screw and followed up prospect ively . In patients with unstable intertrochanteric fractures , the intramedullary device was associated with 23 % less surgical time and 44 % less blood loss ; however , use of the intramedullary hip screw in patients who had a stable fracture pattern required 70 % greater fluoroscopic time . Intraoperative complications occurred exclusively in patients in the intramedullary hip screw group . There were no differences in the rates of functional recovery between the two fixation groups OBJECTIVE To compare minimally invasive dynamic hip screw ( MIDHS ) fixation with conventional dynamic hip screw ( CDHS ) fixation for treatment of intertrochanteric femoral fracture . METHODS Of the 66 participants in this double-blind study , 35 were r and omised to MIDHS and 31 to CDHS fixation .  Main outcome measurements were wound size , haemoglobin decrease , blood transfusion rate , pain score , analgesic consumption , Elderly Mobility Scale score , hip screw position , tip-apex distance , union rate , time to healing and complication rate . RESULTS The groups had similar preoperative clinical data . Postoperatively the MIDHS group had significantly smaller wound size , less blood loss , lower blood transfusion rates , pain scores and rates of analgesic consumption , and higher early Elderly Mobility Scale scores . There were no significant differences in fracture alignment , hip screw position , tip-apex distance , union rate , time to healing or complication rate . CONCLUSION MIDHS fixation of intertrochanteric fractures is effective and safe and significantly reduces blood loss , pain and rehabilitation period , without sacrificing reduction alignment , screw position , fixation stability or bone healing OBJECTIVE To observe and report the clinical results of the treatment of intertrochanteric hip fractures treated with a 135-degree hip screw with a two-hole side plate . DESIGN Prospect i ve consecutive . SETTING Community private practice . PATIENTS A consecutive series of seventy primarily older patients with intertrochanteric hip fractures treated in a community hospital setting . INTERVENTION Surgical treatment with a 135-degree sliding hip screw and a two-hole side plate . MAIN OUTCOME MEASUREMENTS Healing rate and time , operative blood loss and time , incidence of hardware failure , and complications including loss of side plate fixation and amount of collapse . RESULTS Sixty-nine patients , with seventy intertrochanteric hip fractures , underwent surgical treatment with a 135-degree sliding hip screw and a two-hole side plate . There were twenty-one ( 30 percent ) A1.1 , sixteen ( 23 percent ) A1.2 , twenty-one ( 30 percent ) A2.1 , and twelve ( 17 percent ) A2.2 fractures in twenty-three ( 33 percent ) men and forty-six ( 67 percent ) women . Average age was seventy-nine years . The average estimated blood loss was seventy-seven cubic centimeters ( range 10 to 300 cubic centimeters ) , and the average surgical time was thirty-one minutes ( range 8 to 90 minutes ) . The average time to union was fifteen weeks ( range 8 to 17 weeks ) . There were three failures : two from screw cut-out and one from screw plate dissociation . No cases failed due to loss of fixation of the two-hole side plate . Collapse was minimum in fifty-five patients ( 79 percent ) , moderate in twelve patients ( 17 percent ) , and severe in two patients ( 3 percent ) . CONCLUSIONS Use of the 135-degree sliding hip screw with a two-hole side plate produces satisfactory healing and results in relatively low blood loss and short surgical times without the loss of side plate fixation Objective This study evaluates the safety and outcome of a minimally invasive technique for inserting a st and ard dynamic hip screw for intertrochanteric fractures . Hypothesis The use of st and ard plate in a minimally invasive technique is both possible and advantageous to patient outcome . Design and Methods Prospect i ve surgeon-r and omized blinded outcome clinical study comparing new technique to conventional technique . Main Outcome Measure Pain , operative time and mean hemoglobin drop in percutaneous hip fixation . Results The minimally invasive technique had significantly less blood loss ( P < 0.001 ) , operative time ( P < 0.001 ) and a trend to less morphine use . Conclusions Minimal invasive technique significantly reduces blood loss and operative time for fixation of intertrochanteric hip fractures without sacrifice of fixation stability or bone healing The study is a prospect i ve evaluation and comparison . A minimally invasive Dynamic Hip Screw ( MIDHS ) technique is presented . One hundred and two patients with intertrochanteric fractures were treated with either a MIDHS or a conventional dynamic hip screw ( CDHS ) . We used the Singh index as a measure of osteoporosis and also classified the fractures according to three different systems ( OTA , Boyd-Griffin , and Evans ) . All patients were followed up for 12 months with a hip score evaluation . The patients were divided into two groups , based on the method of treatment . The MIDHS group includes 42 patients with an average age of 72.6 years . The CDHS group includes 60 patients , with an average age of 71.3 years . Both groups were similar in injury mechanism , fracture types , mean Singh index and confounding medical condition ( all p values > 0.05 ) . The CDHS group had significantly larger wound incision , greater haemoglobin level drop , higher pain level , more total analgaesic use and longer hospital stay than the MIDHS group ( all p values<0.05 ) . The hip score , union rate , healing time , adequate reduction and adequate screw position rate was not significantly different between the two groups ( all p values > 0.05 ) . In conclusion , either a MIDHS or a CDHS in the treatment of intertrochanteric fractures is an effective , simple and safe method . The mini-invasive technique as opposed to the conventional technique has smaller wound size , lower pain level , and lower blood loss . Hospital stay and total analgaesic use were decreased , benefitting the patient and reducing hospital cost . RésuméEtude prospect i ve de 102 patients avec une fracture intertrochantérienne traitée par une vis-plaque dynamique soit avec une technique mini-invasive ( MIDHS ) soit avec une technique conventionnelle ( CDHS ) . L’index de Singh était utilisé pour la mesure de l’ostéoporose et les fractures étaient classées selon trois systèmes : OTA , Boyd-Griffin et Evans . Tous les patients étaient suivi 1 an . Le groupe  MIDHS  comprenait 42 patients d’âge moyen 72,6 ans et le groupe CDHS comprenait 60 patients d’âge moyen 71,3 ans . Les 2 groupes étaient similaires pour le mécanisme du traumatisme , le type de la fracture , l’index de Singh et les conditions médicales générales ( toujours p<0,05 ) . Le groupe CDHS avait une plus longue incision cutané , une plus gr and e chute du taux d’hémoglobine , un plus haut niveau de douleurs , et un séjour hospitalier plus long que l’autre groupe ( p<0,05 ) . En conclusion les 2 méthodes de traitement étaient efficaces et sûres . La technique mini-invasive permettait une incision plus courte , un niveau de douleurs et une perte sanguine plus faibles . La durée de séjour et la consommation d’analgésiques etaient diminuées au profit du patient et du coût hospitalier Introduction Intertrochanteric fractures of femur are common in elderly patients . The compression hip screw has become the predominant method for osteo synthesis of intertrochanteric fractures . However , the conventional dynamic hip screws ( CDHS ) technique has some disadvantages . Recently , we have used a minimally invasive dynamic hip screws ( MIDHS ) technique to reduce these disadvantages . This prospect i ve study is to compare curative effect of MIDHS with that of CDHS with open reduction on Evans type 1 intertrochanteric fractures . Material s and methods All 97 fractures were classified according to the Evans systems . The MIDHS group included 47 patients with an average age of 68.7 years , and the CDHS group included 50 patients with an average age of 68.7 years . The Singh index was used as a measure of osteoporosis . Results Both groups were similar in injury mechanism , fracture types , mean Singh index and medical diseases ( all P > 0.50 ) . All fractures were healed within 4 months in both groups except three cases who were implant failure and nonunion in the CDHS group . The MIDHS group had significantly smaller wound size , shorter surgery time , less blood loss , lower blood transfusion rate , earlier active mobilization of fractured hip joint , shorter hospital stay , lower serious complication rate and higher Harris hip score than the CDHS group ( all P < 0.05 ) . The satisfactory reduction , adequate screw position , healing time and union rate was not significantly difference between two groups ( all P > 0.05 ) . Conclusion When the fractures are treated adequately , either the MIDHS or the CDHS with open reduction is an effective and safe method , but the MIDHS is superior to the CDHS with open reduction for the treatment of Evans type 1 intertrochanteric fractures of femur The aim of this prospect i ve matched-pair ( age , sex , fracture type , residential status , and walking ability at fracture ) study was to analyse the short-term outcome after Gamma nail ( GN ) and dynamic hip screw ( DHS ) fixation , focusing especially on functional aspects ( St and ardised Audit of Hip Fractures in Europe [ SAHFE ] hip fracture follow-up forms ) , reoperations , and mortality .  Both groups consisted of 134 patients .  DHS and GN groups did not differ significantly with respect to location of residence at 4 months or returning to the prefracture dwelling ( 78 % vs. 73 % , P = 0.224 ) . The change in walking ability at 4 months compared to prefracture situation was better in the DHS group ( p = 0.042 ) , although there was no difference in the change of use of walking aids . The frequency of reoperations during the first year was somewhat lower in the DHS group ( 8.2 % vs. 12.7 % , p = 0.318 ) . Mortality was lower in the DHS group both at 4 months ( 6.0 % vs. 13.4 % , p = 0.061 ) and 12 months ( 14.9 % vs. 23.9 % , p = 0.044 ) . Although walking ability was better and mortality lower in the DHS group , both methods are useful in the treatment of trochanteric femoral fractures . RésuméLe but de cette étude prospect i ve est de comparer et d’analyser le devenir à long terme des fractures du col fémoral traitées par clou Gamma ( GN ) ou par le vis plaque ( DHS ) , notamment en ce qui concerne leurs aspects fonctionnels , les ré interventions et la mortalité .  Deux groupes de 134 patients ont été comparés . Il n’y a pas de différence significative entre ces deux groupes à 4 mois en ce qui concerne le retour aux activités pré-opératoires ( 78 % vs. 73 % , P = 0.224 ) entre DHS et GN . Néanmoins , la marche à 4 mois est bien meilleure dans le groupe DHS ( p = 0.042 ) , il n’y a pas de différence en ce qui concerne l’utilisation d’aide à la marche , moins de ré interventions dans le groupe DHS ( 8,2 % vs. 12,7 % , p = 0.318 ) , de même en ce qui concerne la mortalité ( 6,0 % vs. 13,4 % , p = 0.061 ) et à 12 mois ( 14,9 % vs 23,9 % , p = 0.044 ) . Ces deux méthodes sont utiles dans le traitement des fractures cervico trochantériennes , néanmoins , l’amélioration de la marche et la mortalité sont bien meilleures dans le groupe GHS que dans le groupe clou gamma BACKGROUND The Oxford Levels of Evidence are now routinely assigned at many orthopaedic journals . One disadvantage of this approach is that study design s with a higher level of evidence may be given greater weight than the overall quality of the study merits . In other words , there is no guarantee that research is scientifically valid simply because a more sophisticated study design was employed . The aim of this study was to review Level-I and II therapeutic studies on lateral epicondylitis to measure variation in quality among the highest-level study design s. METHODS Fifty-four prospect i ve r and omized therapeutic trials involving patients with lateral epicondylitis were evaluated by two independent  review ers according to the Oxford Levels of Evidence , a modification of the Coleman Methodology Score ( a 0 to 100-point scale ) , and the revised CONSORT ( Consoli  date d St and ards of Reporting Trials ) score . RESULTS The two review ers were consistent in their use of the Oxford Levels of Evidence ( kappa = 0.73 , p < 0.01 ) , the modified Coleman Methodology Score ( kappa = 0.73 ; p < 0.01 ) , and the CONSORT score ( kappa = 0.53 ; p < 0.01 ) . Both review ers rated the majority of studies as Level II (  
    Output:
    
The MIDHS technique result ed in less blood loss , shorter hospitalization , lower pain level , faster fracture healing , and better hip function when compared with the CDHS technique .
There was no significance difference between the 2 groups with regard to postoperative complications and implant position .
The MIDHS technique may achieve perioperative benefits when compared with the CDHS technique