Intramedullary fixation in Intertrochanteric femoral fracture

Abstract

Intertrochanteric fractures account for nearly 50% of all fractures of the proximal femur. Patient age of incidence is 66 to 76 years. The ratio of women to men ranges from 2:1 to 8:1, likely because of postmenopausal metabolic changes in bone. Trochanteric fractures occur mostly in elderly patients, and the outcome may be extremely poor if there is prolonged bed rest. Stable fixation that allows early mobilization is the treatment of choice. The best treatment for trochanteric fracture remains controversial. Fixation implants include the dynamic hip screw which gain widespread acceptance during last decade but complication is frequent specially in unstable pertrochanteric fracture some of this complication include application of a DHS requires a relatively larger exposure, more tissue handling and an anatomical reduction, all of which increase the morbidity, the probability of infection and significant blood loss, the possibility of varus collapse and the inability of the implant to survive until fracture union