Dynamic Versus Static Distal Interlocking In AO/OTA 31A2 Intertrochanteric Femur Fractures: A Prospective Randomized Controlled Trial

AO/OTA 31A2 intertrochanteric femur fractures are unstable injuries commonly treated with cephalomedullary nailing. However, the optimal distal locking configuration for short proximal femoral nails remains uncertain. This prospective, single-center, parallel-group randomized trial compared dynamic and static distal interlocking of a single short proximal femoral nail design in patients aged 65 years or older with AO/OTA 31A2 fractures. A total of 111 participants were randomized in a 1:1 ratio to dynamic or static distal locking and were followed for a minimum of 24 months. The study evaluated hip function, fracture union and time to union, established non-union, cephalic lag-screw backout, distal cortical thickening, peri-implant fracture, and reoperation or revision surgery.