***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: Purpose The purpose of this prospect i ve r and omised trial was to assess whether an intramedullary nail is superior to a sliding hip screw in the treatment of multifragmentary intertrochanteric fractures Methods Eighty patients with a 31-A2.2 or A2.3 Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association ( AO/OTA ) intertrochanteric fracture were r and omly allocated to fixation with either the Gamma nail or the AMBI sliding hip screw device . Results All patients were followed up at one , three , six and 12 months postoperatively , except for nine who died . There was no statistical difference in Parker mobility score between groups . The Gamma nail group had significantly higher Barthel Index and EuroQol-5D ( EQ-5D ) scores than the AMBI group at 12 months . At the same time , the EQ-5D score had returned to its pre-operative values in the Gamma nail group but not in the AMBI group . There were no differences in mortality , radiation time and hospital stay . Duration of the operation , incision length and hip pain occurrence were significantly less in the Gamma nail group . Conclusions Few failures occur when unstable 31-A2.2 and A2.3 AO/OTA fractures are fixed with a sliding hip screw . Nevertheless , an intramedullary nail seems superior in reconstituting patients to their pre-operative state Background The treatment and management of hip fracture poses a great challenge for clinicians in osteology and surgery . The aim of this study is to compare the clinical effectiveness of the percutaneous compression plate ( PCCP ) versus proximal femoral nail anti-rotation ( PFNA ) in the treatment of intertrochanteric fractures in elderly patients . Methods A prospect i ve r and omized study was carried out from January 2008 to October 2011 involving 90 elderly patients with intertrochanteric fractures ( 90 hips ) who underwent minimally invasive surgery using the PCCP or PFNA .  Evaluation variables , including operation time , intra- and perioperative blood loss , duration of hospital stay , incidence of postoperative complications , and final clinical outcomes by the end of follow-up , were used to compare the benefits of these two implants . Results Among 90 subjects , 45 received PCCPs and 45 received PFNAs . The baseline characteristics of the two groups were comparable . The median follow-up time was 16.9 months ( 12–24 months ) . In the PCCP group , the mean operative time was 53 min ( 40–75 min ) , and the mean intra- and perioperative blood losses were 100.7 ml ( 60–150 ml ) and 916 ml ( 433–1339 ml ) , respectively , which were significantly lower than those in the PFNA group . Nevertheless , there was no statistical difference in the incidence of postoperative complications and final clinical outcomes including pain complaints , range of motion of the hip , postoperative hip function at 12 months , and the recovery of walking ability to pre-injury status between these two implants . Conclusions Overall , the PCCP and PFNA appear to have similar clinical effects in treating elderly patients with intertrochanteric fractures , although the PCCP provided shorter operation times and less blood loss than PFNA . Both implants discussed were demonstrated to be ideal for the treatment of femoral intertrochanteric fractures in elderly patients This study is a r and omized prospect i ve study comparing two fracture fixation implants , the extramedullary sliding hip screw ( SHS ) and the dual lag screw cephalomedullary nail , in the treatment of intertrochanteric femoral fractures in the elderly . One hundred and sixty-five patients with low-energy intertrochanteric fractures , classified as AO/OTA 31A , were prospect ively included during a 2-year period ( 2005–2006 ) . Patients were r and omized into two groups : group A included 79 hip fractures managed with sliding hip screws and group B included 86 fractures treated with cephalomedullary nails .  Delay to surgery , duration of surgery , time of fluoroscopy , total hospital stay , implant-related complications , transfusion requirements , re-operation details , functional recovery , and mortality were recorded . The mean follow-up was 36 months ( 24–56 months ) . The mean surgical time was statistically significantly shorter and fluoroscopy time longer for the group B. No intraoperative femoral shaft fractures occurred . There was no statistically significant difference in the functional recovery score , reoperation , and mortality rates between the 2 groups . A new type of complication , the so-called Z-effect phenomenon , was noticed in the cephalomedullary nail group . There are no statistically significant differences between the two techniques in terms of type and rate of complications , functional outcome , reoperation and mortality rates when comparing the SHS and the cephalomedullary nail for low-energy AO/OTA 31A intertrochanteric fractures . Our data do not support recommendations for the use of one implant over the other Aims To compare the outcomes for trochanteric fractures treated with a sliding hip screw ( SHS ) or a cephalomedullary nail . Patients and Methods A total of 400 patients with a trochanteric hip fracture were r and omised to receive a SHS or a cephalomedullary nail ( Targon PFT ) . All surviving patients were followed up to one year from injury . Functional outcome was assessed by a research nurse blinded to the implant used . Results Recovery of mobility , as assessed by a mobility scale , was superior for those treated with the intramedullary nail compared with the SHS at eight weeks , three and nine months ( p‐values between 0.01 and 0.04 ) , the difference at six and 12 months was not statistically significant ( p = 0.15 and p = 0.18 respectively ) . The mean difference was around 0.4 points ( 0.3 to 0.5 ) on a nine point scale . Surgical time for the nail was four minutes less than that for the SHS ( p < 0.001 ) . Fracture healing complications were similar for the two groups . There were no statistically significant differences between implants for any other recorded outcomes including the need for post‐operative blood transfusion , wound healing complications , general medical complications , hospital stay or mortality . Conclusion This study confirms the findings of a previous study that both methods of treatment produce similar results , although intramedullary fixation does result in marginally improved regain of mobility in comparison with the SHS Objectives : To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw ( SHS ) or InterTAN intramedullary device ( IT ) . Design : Prospect i ve , r and omized , multicenter clinical trial . Setting : Five level 1 trauma centers . Patients : Two hundred forty-nine patients 55 years of age or older with AO/OTA 31A1 ( 43 ) and OA/OTA 31A2 ( 206 ) fractures were prospect ively enrolled and followed for 12 months . Intervention : Computer generated r and omization to either IT ( n = 123 ) or SHS ( n = 126 ) . Main Outcome Measurements : The Functional Independence Measure ( FIM ) and the Timed Up and Go test ( TUG ) were used to measure function and motor performance . Secondary outcome measures included femoral shortening , complications , and mortality . Results : Demographics , comorbidities , preinjury FIM scores and TUG scores were similar between groups . Patients ( 17.2 % ) who received an IT had limb shortening greater than 2 cm compared with 42.9 % who received an SHS ( P < 0.001 ) . To determine the importance of preinjury function and fracture stability , we analyzed the subgroup of patients with the ability to walk 150 m independently preinjury and an OA/OTA 31A-2 fracture ( n = 70 ) . In this subgroup , patients treated with SHS had greater shortening and demonstrated poorer FIM and TUG scores compared with patients treated with an IT . Conclusions : Overall , most patients with intertrochanteric femur fractures can expect similar functional results whether treated with an intramedullary or extramedullary device . However , active , functional patients have an improved outcome when the InterTAN is used to treat their unstable intertrochanteric fracture . Level of Evidence : Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence AIM To compare the functional and radiographic results of  dynamic hip screw ( DHS ) and exp and able proximal femoral nail ( EPFN ) in the treatment of extracapsular hip fractures . METHODS A r and omized controlled trial of sixty hip fracture patients . Outcomes included mortality , residency , independence , mobility , function and radiographic results at a minimum of 1 year . RESULTS Twenty-nine EPFN patients demonstrated fewer cases of shaft medialization or femoral offset shortening compared to the 31 DHS patients . Mortality , complications and functional outcomes were similar . CONCLUSION EPFN provides stable fixation of pertrochanteric hip fractures and prevents neck shortening that is commonly observed after DHS fixation We treated 108 patients with a pertrochanteric femoral fracture using either the  dynamic hip screw or the proximal femoral nail in this prospect i ve , r and omised series . We compared walking ability before fracture , intra-operative variables and return to their residence . Patients treated with the proximal femoral nail ( n = 42 ) had regained their pre-operative walking ability significantly ( p = 0.04 ) more often by the four-month review than those treated with the dynamic hip screw ( n = 41 ) . Peri-operative or immediate post-operative measures of outcome did not differ between the groups , with the exception of operation time . The dynamic hip screw allowed a significantly greater compression of the fracture during the four-month follow-up , but consolidation of the fracture was comparable between the two groups . Two major losses of reduction were observed in each group , result ing in a total of four revision operations . Our results suggest that the use of the proximal femoral nail may allow a faster post-operative restoration of walking ability , when compared with the dynamic hip screw INTRODUCTION Intertrochanteric fractures of the femur are prevalent in the elderly , and leave patients with functional restrictions after surgical treatment . The aim of this study was to compare the functional recovery at 1-year follow-up of elderly patients with intertrochanteric fractures treated surgically with the dynamic hip screw ( DHS ) or proximal femoral nail ( PFN ) fixation techniques . MATERIAL AND METHODS This prospect i ve , r and omised , blinded trial included patients aged over 65 years with intertrochanteric fractures classified as AO group 31.A1 or 31.A2 . The patients were allocated into one of two treatment groups : one treated with DHS and the other with PFN . Data on functional recovery were obtained using the Functional Recovery Score developed by Zuckerman for elderly patients with hip fracture . Variables were described as means and st and ard deviations , and the non-parametric Kolmogorov-Smirnov test was used to verify the normality of data distribution . Non-normally distributed variables were compared using the non-parametric Friedman and Mann-Whitney U tests . Data processing and analysis were carried out in SPSS 10.0 . Results were deemed significant at the 5 % level ( p ≤ 0.05 ) . RESULTS There were no significant between-group differences in age ( p=0.152 ) , sex ( p=0.363 ) , or American Society of Anaesthesiologists ( ASA ) score ( p=0.579 ) . Functional recovery scores in the DHS group at 3 and 6 months after surgery were significantly reduced from preoperative baseline scores ( p=0.007 ) compared with in the PFN group . However , there were no statistically significant differences between the two groups in functional recovery scores at baseline ( p=0.346 ) or at 3 months ( p=0.880 ) , 6 months ( p=0.699 ) , and 12 months ( p=0.468 ) after surgery . There was no between-group difference in mortality ( p=0.140 ) . CONCLUSION At 1-year follow-up , functional recovery scores were similar in elderly patients treated with the DHS and PFN techniques . However , DHS-treated patients exhibited significant loss of function in the first 6 months after surgery , which did not occur in the PFN-treated group Introduction : In this study , we initiated a prospect i ve , r and omised , clinical trial comparing the AMBI , TGN and PFN operations used for treatment of unstable fractures , for differences in intra-operative use , consolidation , complications and functional outcome . Material s and methods : We have compared the pre- , intra- and post-operating variables of AMBI , TGN and PFN operations that were used for treatment of unstable trochanteric fractures , of 120 patients all above 60 years old diagnosed with extracapsular hip fractures classified as AO Type 31-A2 or Type 31-A3 . Results : According to our results the three methods are comparable in the treatment of unstable trochanteric fractures  of patients above 60 years old . Conclusion : The AMBI remains the gold st and ard for the fractures of trochanteric region . TGN has an easier and faster procedure , facilitates early weight bearing and had minor late complications . An improper use of the PFN system was the reason for the most complications and the longer operation time of the device . PFN is also an accepted minimally invasive implant for unstable proximal femoral fract 
    Output:
    
Bases on the evidence to date from r and omised trials , the use of fixed nail plates for surgical fixation of this type of fracture can not be justified .
Intramedullary nail fixation and the sliding hip screw have comparable fracture healing complication rates