Femoral Shortening After Surgical Treatment of Trochanteric Fractures in Nongeriatric Patients

Abstract

Femoral shortening after operative treatment of per- and intertrochanteric fractures was found to be a common clinical finding in nongeriatric patients. Nearly half of them showed a lower limb length inequality after fracture fixation. The degree of the shortening was rather low and depended mainly on the fracture type. Comparing the two different implants used for operative treatment, a cephalomedullary nail was more successful in preventing limb length discrepancy in unstable fracture types than dynamic hip screw.

Comparison of clinical outcomes with three different intramedullary nailing devices in treatment of unstable trochanteric fractures

“…[10] However, these data seem to exacerbate rather than restrict the use of intramedullary nailing, especially during the few years. Surgeons are likely to be convinced getting rid of known dysadvantages of hip screws including excessive collapse, femoral shortening [11] and late recovery of normal mobility, [12] at the expense of incresing cost. [13] Type of the fracture should be regarded as an important factor in designing future studies since more unstable fractures of the femoral head (i.e having an extending component through the femoral shaft, AO-A3) may require a distinct approach in the given patient.…”

The Effect of Fracture Pattern Stability on Implant Loading in OTA Type 31-A2 Proximal Femur Fractures

“…[10][11][12] However, recent studies report that SHS-IMN compared with SHS-P constructs have decreased shortening, nonunion, and implant failure rates when treated highly unstable intertrochanteric fractures. [13][14][15] This may suggest the importance of determining fracture instability before choosing an implant for fixation.…”

3066 consecutive Gamma Nails. 12 years experience at a single centre

“…This is due to several perceived advantages, such as minimal invasive technique allowing for short skin incisions and less blood loss compared with other techniques requiring more surgical exposure [3-6], reduced infection rate, minimal tissue damage, a shorter operating time and early weight bearing [7,8]. The intramedullary position of the Gamma Nail provides a short lever arm for the cephalic screw, still allowing controlled impaction of the fracture [3,4,9-14], but probably with less shortening than with sliding hip screw systems [15]. …”