Intramedullary Nailing vs. Sliding Hip Screw Intertrochanteric Evaluation: The INSITE Trial

Description

In a recent presentation, Emil Schemitsch discussed the results of the INSITE trial, focusing on trochanteric fractures, which are prevalent in older populations and constitute about half of hip fractures. The study aimed to compare health-related quality of life outcomes between two surgical treatments: intramedullary nailing (IMN) and sliding hip screws. Conducted across 25 international sites, the Multicenter Randomized Controlled Trial included 850 patients who were randomly assigned to receive either treatment, excluding those with significant comorbidities or complications.



The primary outcome measured at 52 weeks was health-related quality of life, assessed using the EQ5D scale. Secondary outcomes involved fracture healing, mobility, and adverse events. Despite screening nearly 4,000 patients, results showed no significant differences in quality of life, mobility, function, or adverse events between the two methods. Limitations included a high dropout rate, though efforts were made to account for missing data. Overall, the findings suggest that there is no compelling evidence to favor increased use of IM nailing over sliding hip screws for treating trochanteric fractures.

DOI: 10.1302/3114-220964

Specialties