Nail Length in the Management of Intertrochanteric Fracture of the Femur

作者：Daniel S. Horwitz, Akhil Tawari, Michael Suk · 发表于：Journal of the American Academy of Orthopaedic Surgeons · 年份：2016 · DOI：10.5435/jaaos-d-15-00325 · 被引用次数：68 · 研究领域：Hip and Femur Fractures、Orthopaedic implants and arthroplasty、Bone fractures and treatments

Intramedullary devices are used increasingly to treat intertrochanteric femur fractures, especially those with unstable patterns. In spite of the considerable use of nails in the management of these fractures, opinions differ about the correct length of intramedullary nail. Long nails were developed to address the risk of diaphyseal fracture associated with earlier short nail designs and to extend the indications for use to include diaphyseal and subtrochanteric fractures. Several recent studies, however, have found no differences between modern short nails and long nails with regard to union and complication rates. In the absence of existing guidelines, the treating surgeon's preference and fracture characteristics continue to influence the decision of whether to use short nails or long nails. The surgeon needs to consider the fracture configuration and related factors, including whether osteoporosis is present and the cost and risk of revision surgery, when selecting the appropriate nail length.