Surgical Management of Hip Fractures: An Evidence-based Review of the Literature. II: Intertrochanteric Fractures

Which Fixation Device is Preferred for Surgical Treatment of Intertrochanteric Hip Fractures in the United States? A Survey of Orthopaedic Surgeons

“…Short nail proponents chose ease of technique (59%) and equivalency of outcomes to a long nail (24%) as their reasons for using short cephalomedullary nails. Studies have suggested a higher risk of periimplant fracture with cephalomedullary nails compared with sliding hip screws [19,25,28], but Norris et al [25] found that newer designs of cephalomedullary nails have a significantly decreased rate of periimplant fracture compared with their predecessors. Boone et al [6] performed a retrospective study of intertrochanteric fractures treated with either a long or short cephalomedullary nail with minimum 1-year followup, finding no difference in the rate of periimplant fracture.…”

“…Intertrochanteric fractures comprise approximately 50% of these. Historically, a sliding compression screw has been the preferred implant [19,28,30,34]; however, cephalomedullary nailing has become an increasingly popular fixation technique for these fractures since its introduction in the 1980s [2,7,12]. Cephalomedullary nailing has theoretical advantages of being less invasive and biomechanically superior, providing a buttress to limit fracture collapse [21].…”

Avaliação prospectiva da evolução clínica, radiográfica e funcional do tratamento das fraturas trocantéricas instáveis do fêmur com haste cefalomedular

“…In the United States, the expenditure is expected to rise from 8.7 billion in it diminishes the complications resulting from prolonged restriction to bed (2) .…”

“…Osteosynthesis of trochanteric fractures is the principal surgical treatment method, although replacement using a prosthesis is occasionally indicated (2) .…”

“…of increasing life expectancy among the population (1) . It has been estimated that nine out of every ten trochanteric fractures occur in individuals over the age of 65 years (2) . Around one in every 1000 inhabitants per year, in developed countries, is affected by fractures of the proximal femur (3) .…”