Sliding hip screw versus IM nail in reverse oblique trochanteric and subtrochanteric fractures. A study of 2716 patients in the Norwegian Hip Fracture Register

Abstract

12 months postoperatively patients with transverse/reverse oblique trochanteric and subtrochanteric fractures operated with a SHS had a higher reoperation rate compared to those operated with an IM nail. Small differences regarding pain, satisfaction, quality of life, and mobility were also in favour of IM nailing. Consequently, a change in our treatment strategy for these fractures could be considered.

Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials

“…DHS, the most representative implant of extramedullary fixation, has been considered the gold standard for treatment of intertrochanteric fractures. However, the failure rate of DHS is higher [10,21] in the unstable and reverse oblique fracture, which limits its clinical use [11,16]. Gotfried developed the PCCP technique; however, the PCCP lengthens operation time and increases biomechanical complications [12].…”

Arthroplasty for unstable pertrochanteric hip fractures may offer a lower re-operation rate as compared to cephalomedullary nailing

“…However, in patients with unstable fracture patterns the results have been poor due to hardware related failure and lag screw cut-out [7]. Both biomechanical and clinical data suggest that CM nails have a mechanical advantage over extra-medullary implants in their ability to resist femoral shaft medialization and varus malunion, and this has led to the increased use of CM nails for hip fractures [8][9][10][11]. However, recent studies showed that there is still a high revision rate for unstable hip fractures treated with CM nails mainly due to cut-out of the lag screw [12,13].…”

New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures

“…In addition, appropriate implants should be selected for fixation of the distal primary fragment, and postoperative stable reduction should be achieved. As clinical outcomes for the patients using SHS were poor, an intramedullary nail (IMN), such as SFN and long femoral nail (LFN), tended to be recommended [14][15][16][17][18][19]. However, it has not been clear whether LFN or SFN should be used in the different types of intertrochanteric fractures.…”