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Intertrochanteric fractures: a review of fixation methods

  • Expert's Opinion • HIP - FRACTURES
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Fig. 1

References

  1. Kosygan KP, Mohan R, Newman RJ (2002) The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. J Bone Joint Surg Br 84:1922

    Article  Google Scholar 

  2. Garg B, Marimuthu K, Kumar V, Malhotra R, Kotwal PP (2011) Outcome of short proximal femoral nail antirotation and dynamic hip screw for fixation of unstable trochanteric fractures. A randomised prospective comparative trial. Hip Int 21:531–536

    Article  PubMed  Google Scholar 

  3. Yang E, Qureshi S, Trokhan S, Joseph D (2011) Gotfried percutaneous compression plating compared with sliding hip screw fixation of intertrochanteric hip fractures: a prospective randomized study. J Bone Joint Surg Am 93:942–947

    Article  PubMed  Google Scholar 

  4. Baumgaertner MR, Curtin SL, Lindskog DM (1998) Intramedullary versus extramedullary fixation for the treatment of intertrochanteric hip fractures. Clin Orthop Relat Res 348:87–94

    PubMed  Google Scholar 

  5. McCormack R, Panagiotopolous K, Buckley R, Penner M, Perey B, Pate G, Goetz T, Piper M (2013) A multicentre, prospective, randomised comparison of the sliding hip screw with the Medoff sliding screw and side plate for unstable intertrochanteric hip fractures. Injury 44:1904–1909

    Article  CAS  PubMed  Google Scholar 

  6. Lunsjo K, Ceder L, Thorngren KG, Skytting B, Tidermark J, Berntson PO, Allvin I, Norberg S, Hjalmars K, Larsson S, Knebel R, Hauggaard A, Stigsson L (2001) extramedullary fixation of 569 unstable intertrochanteric fractures: a randomized multicenter trial of the Medoff sliding plate versus three other screw-plate systems. Acta Orthop Scand 72:133–140

    Article  CAS  PubMed  Google Scholar 

  7. Saudan M, Lubbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P (2002) Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma 16:386393

    Google Scholar 

  8. Parker MJ, Bowers TR, Pryor GA (2012) Sliding hip screw versus the Targon PF nail in the treatment of trochanteric fractures of the hip: a randomised trial of 600 fractures. J Bone Joint Surg Br 94:391–397

    Article  CAS  PubMed  Google Scholar 

  9. Parker MJ, Handoll HH (2010) Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extra capsular hip fractures in adults. Cochrane Database Sits Rev CD000093

  10. Little NJ, Verma V, Fernando C, Elliott DS, Khaleel A (2008) A prospective trial comparing the Holland nail with the dynamic hip screw in the treatment of intertrochanteric fractures of the hip. J Bone Joint Surg Br 90:1073–1078

    Article  CAS  PubMed  Google Scholar 

  11. Hardy DCR, Descamps P-Y, Krallis P, Fabeck L, Smets P, Bertens CL, Delince PE (1998) Use of an intramedullary hip-screw compared with a compression hip-screw with a plate for intertrochanteric femoral fractures. A prospective, randomized study of one hundred patients. J Bone Joint Surg Am 80(5):618–630

    CAS  PubMed  Google Scholar 

  12. Peyser A, Weil YA, Brocke L, Sela Y, Mosheiff R, Mattan Y, Manor O, Liebergall M (2007) A prospective, randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip. J Bone Joint Surg Br 89:1210–1217

    Article  CAS  PubMed  Google Scholar 

  13. Zou J, Xu Y, Yang H (2009) A comparison of proximal femoral nail antirotation and dynamic hip screw devices in trochanteric fractures. J Int Med Res 37:1057–1064

    Article  CAS  PubMed  Google Scholar 

  14. Adams CI, Robinson CM, Court-Brown CM, McQueen MM (2001) Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur. J Orthop Trauma 15:394–400

    Article  CAS  PubMed  Google Scholar 

  15. Barton TM, Gleeson R, Topliss C, Greenwood R, Harries WJ, Chesser TJ (2010) a comparison of the long gamma nail with the sliding hip screw for the treatment of AO/OTA 31-A2 fractures of the proximal part of the femur: a prospective randomized trial. J Bone Joint Surg Am 92:792–798

    Article  PubMed  Google Scholar 

  16. Bridle SH, Patel AD, Bircher M, Calvert PT (1991) Fixation of intertrochanteric fractures of the femur. A randomised prospective comparison of the gamma nail and the dynamic hip screw. J Bone Joint Surg Br 73:330–334

    CAS  PubMed  Google Scholar 

  17. Ahrengart L, Tornkvist H, Fornander P, Thorngren KG, Pasanen L, Wahlstrom P, Honkonen S, Lindgren U (2002) a randomized study of the compression hip screw and Gamma nail in 426 fractures. Clin Orthop Relat Res 401:209–222

    Article  PubMed  Google Scholar 

  18. Matre K, Havelin LI, Gjertsen JE, Vinje T, Espehaug B, Fevang JM (2013) Sliding hip screw versus IM nail in reverse oblique trochanteric and subtrochanteric fractures. A study of 2716 patients in the Norwegian Hip Fracture Register. Injury 44:735–742

    Article  PubMed  Google Scholar 

  19. Fang C, Lau TW, Wong TM, Lee HL, Leung F (2015) Sliding hip screw versus sliding helical blade for intertrochanteric fractures: a propensity score-matched case control study. Bone Joint J 97B:398–404

    Article  Google Scholar 

  20. Macheras G, Galanakos S, Koutsostathis S, Kateros K, Karras A, Papadakis S (2013) Unstable pertrochanteric fractures. A comparison of preliminary results using three different methods of fixation, Acta Orthopaedica et Traumatologica Hellenica 64

    Google Scholar 

  21. Lenich A, Bachmeier S, Prantl L, Nerlich M, Hammer J, Mayr E, AlMunajjed AA, Fuchtmeier B (2011) Is the rotation of the femoral head a potential initiation for cutting out? A theoretical and experimental approach. BMC Musculoskeletal Disord 12:79

    Article  Google Scholar 

  22. Weiser L, Ruppel AA, Nuchtern JV, Sellenschloh K, Zeichen J, Puschel K, Morlock MM, Lehmann W (2015) Extra- versus intramedullary treatment of pertrochanteric fractures: a biomechanical in vitro study comparing dynamic hip screw and intramedullary nail. Arch Orthop Trauma Surg 135:1101–1106

    Article  PubMed  Google Scholar 

  23. O’Neill F, Condon F, McGloughlin T, Lenehan B, Coffey JC, Walsh M (2011) Dynamic hip screw versus DHS blade: a biomechanical comparison of the fixation achieved by each implant in bone. J Bone Joint Surg Br 93:616–621

    Article  PubMed  Google Scholar 

  24. Sommers MB, Roth C, Hall H, Kam BC, Ehmke LW, Krieg JC, Madey SM, Bottlang M (2004) A laboratory model to evaluate cutout resistance of implants for pertrochanteric fracture fixation. J Orthop Trauma 18(361):368

    Google Scholar 

  25. Luo Q, Yuen G, Lau TW, Yeung K, Leung F (2013) A biomechanical study comparing helical blade with screw design for sliding hip fixations of unstable intertrochanteric fractures. ScientificWorldJournal 2013:1–6

    Google Scholar 

  26. Kouvidis GK, Sommers MB, Giannoudis PV, Katonis PG, Bottlang M (2009) Comparison of migration behavior between single and dual lag screw implants for intertrochanteric fracture fixation. J Orthop Surg Res 4:16

    Article  PubMed  PubMed Central  Google Scholar 

  27. Goffin JM, Pankaj P, Simpson AH (2013) The importance of lag screw position for the stabilization of trochanteric fractures with a sliding hip screw: a subject-specific finite element study. J Orthop Res 31(596–600):28

    Google Scholar 

  28. Curtis MJ, Jinnah RH, Wilson V, Cunningham BW (1994) Proximal femoral fractures: a biomechanical study to compare intramedullary and extramedullary fixation. Injury 25:99–104

    Article  CAS  PubMed  Google Scholar 

  29. Al-Munajjed AA, Hammer J, Mayr E, Nerlich M, Lenich A (2008) Biomechanical characterisation of osteosyntheses for proximal femur fractures: helical blade versus screw. Stud Health Technol Inform 133:110

    Google Scholar 

  30. Yu J, Zhang C, Li L, Kwong JS, Xue L, Zeng X, Tang L, Li Y, Sun X (2015) Internal fixation treatments for intertrochanteric fracture: a systematic review and meta-analysis of randomized evidence. Sci Rep 5:18195

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Ma KL, Wang X, Luan FJ, Xu HT, Fang Y, Min J, Luan HX, Yang F, Zheng H, He SJ (2014) Proximal femoral nails antirotation, Gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur: a meta-analysis. Orthop Traumatol Surg Res 100:859–866

    Article  PubMed  Google Scholar 

  32. Shen L, Zhang Y, Shen Y, Cui Z (2013) Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures: a metaanalysis of randomized controlled studies. Orthop Traumatol Surg Res 99:377–383

    Article  CAS  PubMed  Google Scholar 

  33. Bhandari M, Schemitsch E, Jonsson A, Zlowodzki M, Haidukewych GJ (2009) Gamma nails revisited: gamma nails versus compression hip screws in the management of intertrochanteric fractures of the hip: a metaanalysis. J Orthop Trauma 23:460–464

    Article  PubMed  Google Scholar 

  34. Windolf M, Braunstein V, Dutoit C, Schwieger K (2009) Is a helical shaped implant a superior alternative to the Dynamic Hip Screw for unstable femoral neck fractures? A biomechanical investigation. Clin Biomech 24:59–64

    Article  Google Scholar 

  35. Haidukewych GJ, Israel TA, Berry DJ (2001) Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am 83A:643–650

    Google Scholar 

  36. Kregor PJ, Obremskey WT, Kreder HJ, Swiontkowski MF (2014) Unstable pertrochanteric femoral fractures. J Orthop Trauma 28(Suppl 8):S25–S28

    Article  PubMed  Google Scholar 

  37. Kregor PJ, Obremskey WT, Kreder HJ, Swiontkowski MF, Evidence based orthopaedic trauma working Group (2005) Unstable pertrochanteric femoral fractures. J Orthop Trauma 19:63–66

    Article  PubMed  Google Scholar 

  38. Haidukewych GJ (2009) Intertrochanteric fractures: ten tips to improve results. J Bone Joint Surg Am 91:712–719

    PubMed  Google Scholar 

  39. Pervez H, Parker MJ, Vowler S (2004) Prediction of fixation failure after sliding hip screw fixation. Injury 35:994–998

    Article  PubMed  Google Scholar 

  40. De Bruijn K, den Hartog D, Tuinebreijer W, Roukema G (2012) Reliability of predictors for screw cutout in intertrochanteric hip fractures. J Bone Joint Surg Am 94:1266–1272

    Article  PubMed  Google Scholar 

  41. Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM (1995) The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am 77:1058–1064

    CAS  PubMed  Google Scholar 

  42. Baumgaertner MR, Solberg BD (1997) Awareness of tip-apex distance reduces failure of fixation of trochanteric fractures of the hip. J Bone Joint Surg Br 79:969–971

    Article  CAS  PubMed  Google Scholar 

  43. Andruszkow H, Frink M, Fromke C, Matityahu A, Zeckey C, Mommsen P, Suntardjo S, Krettek C, Hildebrand F (2012) Tip apex distance, hip screw placement, and neck shaft angle as potential risk factors for cut-out failure of hip screws after surgical treatment of intertrochanteric fractures. Int Orthop 36:2347–2354

    Article  PubMed  PubMed Central  Google Scholar 

  44. Hsueh KK, Fang CK, Chen CM, Su YP, Wu HF, Chiu FY (2010) Risk factors in cutout of sliding hip screw in intertrochanteric fractures: an evaluation of 937 patients. Int Orthop 34:1273–1276

    Article  PubMed  PubMed Central  Google Scholar 

  45. Fitzpatrick DC, Sheerin DV, Wolf BR, Wuest TK (2011) A randomized, prospective study comparing intertrochanteric hip fracture fixation with the dynamic hip screw and the dynamic helical hip system in a community practice. Iowa Orthop J 31:166–172

    PubMed  PubMed Central  Google Scholar 

  46. Huang X, Leung F, Liu M, Chen L, Xu Z, Xiang Z (2014) Is helical blade superior to screw design in terms of cut-out rate for elderly trochanteric fractures? A meta-analysis of randomized controlled trials. Eur J Orthop Surg Traumatol 24:1461–1468

    Article  PubMed  Google Scholar 

  47. Hwang JH, Garg AK, Oh JK, Oh CW, Lee SJ, Myung-Rae C, Kim MK, Kim H (2012) A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: a cadaveric study. Indian J Orthop 46:627–632

    Article  PubMed  PubMed Central  Google Scholar 

  48. Lenich A, Fierlbeck J, Al-Munajjed A, Dendorfer S, Mai R, Fuchtmeier B, Mayr E, Hammer J (2006) First clinical and biomechanical results of the Trochanteric Fixation Nail (TFN). Technol Health Care 14:403–409

    CAS  PubMed  Google Scholar 

  49. Simmermacher RK, Ljungqvist J, Bail H, Hockertz T, Vochteloo AJ, Ochs U, Werken C, Studygroup AP (2008) The new proximal femoral nail antirotation (PFNA) in daily practice: results of a multicentre clinical study. Injury 39:932–939

    Article  CAS  PubMed  Google Scholar 

  50. O’Malley NT, Deeb AP, Bingham KW, Kates SL (2012) Outcome of the dynamic helical hip screw system for intertrochanteric hip fractures in the elderly patients. Geriatr Orthop Surg Rehabil 3:68–73

    Article  PubMed  PubMed Central  Google Scholar 

  51. Swart E, Makhni EC, Macaulay W, Rosenwasser MP, Bozic KJ (2014) Cost-effectiveness analysis of fixation options for intertrochanteric hip fractures. J Bone Joint Surg Am 96:1612–1620

    Article  PubMed  Google Scholar 

  52. Anglen JO, Weinstein JN (2008) Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American board of orthopaedic surgery database. J Bone Joint Surg Am 90:700–707

    Article  PubMed  Google Scholar 

  53. O’Brien PJ, Meek RN, Blachut PA, Broekhuyse HM, Sabharwal S (1995) Fixation of intertrochanteric hip fractures: gamma nail versus dynamic hip screw. A randomized, prospective study. Can J Surg 38:516520

    Google Scholar 

  54. Winnock de Grave P, Tampere T, Byn P, Van Overschelde J, Pattyn C, Verdonk R (2012) Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs. A prospective randomised clinical trial. Acta Orthop Belg 78:192–198

    PubMed  Google Scholar 

  55. Herrera A, Domingo LJ, Calvo A, Martinez A, Cuenca J (2002) A comparative study of trochanteric fractures treated with the Gamma nail or the proximal femoral nail. Int Orthop 26:365–369

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Utrilla AL, Reig JS, Munoz FM, Tufanisco CB (2005) Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma 19:229–233

    Article  PubMed  Google Scholar 

  57. Vaquero J, Munoz J, Prat S, Ramirez C, Aguado HJ, Moreno E, Perez MD (2012) Proximal Femoral Nail Antirotation versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study. Injury 43(Suppl 2):S47–S54

    PubMed  Google Scholar 

  58. Schipper IB, Steyerberg EW, Castelein RM, van der Heijden FH, den Hoed PT, Kerver AJ, van Vugt AB (2004) Treatment of unstable trochanteric fractures. Randomised comparison of the gamma nail and the proximal femoral nail. J Bone Joint Surg Br 86:86–94

    CAS  PubMed  Google Scholar 

  59. Kukla C, Heinz T, Gaebler C, Heinze G, Vecsei V (2001) The standard Gamma nail: a critical analysis of 1000 cases. J Trauma 51:77–83

    Article  CAS  PubMed  Google Scholar 

  60. Saarenpaa I, Heikkinen T, Ristiniemi J, Hyvonen P, Leppilahti J, Jalovaara P (2009) Functional comparison of the dynamic hip screw and the Gamma locking nail in trochanteric hip fractures: a matched-pair study of 268 patients. Int Orthop 33:255–260

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Bjorgul K, Reikeras O (2007) Outcome after treatment of complications of Gamma nailing: a prospective study of 554 trochanteric fractures. Acta Orthop 78:231–235

    Article  PubMed  Google Scholar 

  62. Abram SG, Pollard TC, Andrade AJ (2013) Inadequate ‘three-point’ proximal fixation predicts failure of the Gamma nail. Bone Joint J 95B:825–830

    Article  Google Scholar 

  63. von Ruden C, Hungerer S, Augat P, Trapp O, Buhren V, Hierholzer C (2015) Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures. Arch Orthop Trauma Surg 135:179–185

    Article  Google Scholar 

  64. Bojan AJ, Beimel C, Speitling A, Taglang G, Ekholm C, Jonsson A (2010) 3066 consecutive Gamma Nails. 12 years experience at a single centre. BMC Musculoskelet Disord 11:133

    Article  PubMed  PubMed Central  Google Scholar 

  65. Rosenblum SF, Zuckerman JD, Kummer FJ, Tam BS (1992) A biomechanical evaluation of the Gamma nail. J Bone Joint Surg Br 74:352357

    Google Scholar 

  66. Butt MS, Krikler SJ, Nafie S, Ali MS (1995) Comparison of dynamic hip screw and gamma nail: a prospective, randomized, controlled trial. Injury 26:615–618

    Article  CAS  PubMed  Google Scholar 

  67. Iwakura T, Niikura T, Lee SY, Sakai Y, Nishida K, Kuroda R, Kurosaka M (2013) Breakage of a third generation gamma nail: a case report and review of the literature. Case Rep Orthop 2013:172352

    PubMed  PubMed Central  Google Scholar 

  68. Rerri BE, Ayorinde RO, Opadele T, Onayemi B (2011) Short gamma nail fixation for intertrochanteric fractures in the elderly. Eur J Orthop Surg Traumatol 21:275–279

    Article  Google Scholar 

  69. Efstathopoulos NE, Nikolaou VS, Lazarettos JT (2007) Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs. Int Orthop 31:71–76

    Article  PubMed  PubMed Central  Google Scholar 

  70. Buecking B, Bliemel C, Struewer J, Eschbach D, Ruchholtz S, Muller T (2012) Use of the Gamma3 nail in a teaching hospital for trochanteric fractures: mechanical complications, functional outcomes, and quality of life. BMC Res Notes 5:651

    Article  PubMed  PubMed Central  Google Scholar 

  71. Wu D, Ren G, Peng C, Zheng X, Mao F, Zhang Y (2014) InterTan nail versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. Diagn Pathol 9:191

    Article  PubMed  PubMed Central  Google Scholar 

  72. D’Arrigo C, Carcangiu A, Perugia D, Scapellato S, Alonzo R, Frontini S, Ferretti A (2012) Intertrochanteric fractures: comparison between two different locking nails. Int Orthop 36:2545–2551

    Article  PubMed  PubMed Central  Google Scholar 

  73. Karn NK, Jain A, Nepal P, Singh MP, Das N (2011) A prospective randomized control trial comparing proximal femoral nail and sliding hip screw in the management of trochanteric fracture of the femur. Health Renaissance 9:7–11

    Google Scholar 

  74. Kumar V, Singh A, Bharti A, Dalmia D, Ali S (2014) A comparison of intramedullary and extramedullary fixation devices in unstable trochanteric fractures. Int J Biomed Adv Res 05:335–339

    Article  CAS  Google Scholar 

  75. Ozkan K, Cift H, Akan K, Sahin A, Eceviz E, Ugutmen E (2010) Proximal femoral nailing without a fracture table. Eur J Orthop Surg Traumatol 20:229–231

    Article  Google Scholar 

  76. Ozkan K, Turkmen I, Sahin A, Yildiz Y, Erturk S, Soylemez MS (2015) A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation: a study on synthetic bones. Indian J Orthop 49:347–351

    Article  PubMed  PubMed Central  Google Scholar 

  77. Korkmaz MF, Erdem MN, Disli Z, Selcuk EB, Karakaplan M, Gogus A (2014) Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases. Clin Interv Aging 9:569–574

    Article  PubMed  PubMed Central  Google Scholar 

  78. Koyuncu S, Altay T, Kayali C, Ozan F, Yamak K (2015) Mechanical failures after fixation with proximal femoral nail and risk factors. Clin Interv Aging 10:1959–1965

    Article  PubMed  PubMed Central  Google Scholar 

  79. Morihara T, Arai Y, Tokugawa S, Fujita S, Chatani K, Kubo T (2007) Proximal femoral nail for treatment of trochanteric femoral fractures. J Orthop Surg (Hong Kong) 15:273–277

    CAS  Google Scholar 

  80. Cheema GS, Rastogi A, Singh V, Goel SC, Mishra D, Arora S (2012) Comparison of cutout resistance of dynamic condylar screw and proximal femoral nail in reverse oblique trochanteric fractures: a biomechanical study. Indian J Orthop 46:259–265

    Article  PubMed  PubMed Central  Google Scholar 

  81. Schipper IB, Bresina S, Wahl D, Linke B, Van Vugt AB, Schneider E (2002) Biomechanical evaluation of the proximal femoral nail. Clin Orthop Relat Res 405:277–286

    Article  PubMed  Google Scholar 

  82. Ozkan K, Eceviz E, Unay K, Tasyikan L, Akman B, Eren A (2011) Treatment of reverse oblique trochanteric femoral fractures with proximal femoral nail. Int Orthop 35:595–598

    Article  PubMed  PubMed Central  Google Scholar 

  83. Norris R, Bhattacharjee D, Parker MJ (2012) Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures: a systematic review of 13,568 patients. Injury 43:706–711

    Article  PubMed  Google Scholar 

  84. Papasimos S, Koutsojannis CM, Panagopoulos A, Megas P, Lambiris E (2005) A randomised comparison of AMBI, TGN and PFN for treatment of unstable trochanteric fractures. Arch Orthop Trauma Surg 125:462–468

    Article  CAS  PubMed  Google Scholar 

  85. Pires RE, Santana EO Jr, Santos LE, Giordano V, Balbachevsky D, Dos Reis FB (2011) Failure of fixation of trochanteric femur fractures: clinical recommendations for avoiding Z-effect and reverse Z-effect type complications. Patient Saf Surg 5:17

    Article  PubMed  PubMed Central  Google Scholar 

  86. Konstantinidis L, Papaioannou C, Blanke P, Hirschmuller A, Sudkamp NP, Helwig P (2013) Failure after osteosynthesis of trochanteric fractures. Where is the limit of osteoporosis? Osteoporos Int 24:2701–2706

    Article  CAS  PubMed  Google Scholar 

  87. Raviraj A, Anand A, Chakravarthy M, Pai S (2012) Proximal femoral nail antirotation (PFNA) for treatment of osteoporotic proximal femoral fractures. Eur J Orthop Surg Traumatol 22:301–305

    Article  Google Scholar 

  88. Erhart S, Schmoelz W, Blauth M, Lenich A (2011) Biomechanical effect of bone cement augmentation on rotational stability and pull-out strength of the Proximal Femur Nail Antirotation. Injury 42:1322–1327

    Article  CAS  PubMed  Google Scholar 

  89. Guo Q, Shen Y, Zong Z, Zhao Y, Liu H, Hua X, Chen H (2013) Percutaneous compression plate versus proximal femoral nail anti-rotation in treating elderly patients with intertrochanteric fractures: a prospective randomized study. J Orthop Sci 18:977–986

    Article  PubMed  PubMed Central  Google Scholar 

  90. Huang Y, Zhang C, Luo Y (2013) A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures. Int Orthop 37:2465–2473

    Article  PubMed  PubMed Central  Google Scholar 

  91. Knobe M, Nagel P, Maier KJ, Gradl G, Buecking B, Sonmez TT, Modabber A, Prescher A, Pape HC (2016) Rotationally stable screw-anchor with locked trochanteric stabilizing plate versus proximal femoral nail antirotation in the treatment of AO/OTA 31A2.2 fracture: a biomechanical evaluation. J Orthop Trauma 30:e12–e18

    Article  PubMed  Google Scholar 

  92. Liu Y, Tao R, Liu F, Wang Y, Zhou Z, Cao Y, Wang H (2010) Mid-term outcomes after intramedullary fixation of peritrochanteric femoral fractures using the new proximal femoral nail antirotation (PFNA). Injury 41:810–817

    Article  PubMed  Google Scholar 

  93. Macheras GA, Koutsostathis SD, Galanakos S, Kateros K, Papadakis SA (2012) Does PFNA II avoid lateral cortex impingement for unstable peritrochanteric fractures? Clin Orthop Relat Res 470:3067–3076

    Article  PubMed  PubMed Central  Google Scholar 

  94. Stern R, Lubbeke A, Suva D, Miozzari H, Hoffmeyer P (2011) Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures. Int Orthop 35:1855–1861

    Article  PubMed  PubMed Central  Google Scholar 

  95. Sawaguchi T, Sakagoshi D, Shims Y, Ito T, Goldhahn S (2014) Do Design adaptations of a trochanteric nail make sense for Asian patients? Results of a multicenter study of the PFNA-II in Japan. Injury 45:16241631

    Article  Google Scholar 

  96. Takigami I, Matsumoto K, Ohara A, Yamanaka K, Naganawa T, Ohashi M, Date K, Shimizu K (2008) Treatment of trochanteric fractures with the PFNA (proximal femoral nail antirotation) nail system—report of early results. Bull NYU Hosp Jt Dis 66:276–279

    PubMed  Google Scholar 

  97. Tang P, Hu F, Shen J, Zhang L, Zhang L (2012) Proximal femoral nail antirotation versus hemiarthroplasty: a study for the treatment of intertrochanteric fractures. Injury 43:876–881

    Article  PubMed  Google Scholar 

  98. Tao R, Lu Y, Xu H, Zhou ZY, Wang YH, Liu F (2013) Internal fixation of intertrochanteric hip fractures: a clinical comparison of two implant designs. ScientificWorldJournal 2013:834825

    Article  PubMed  PubMed Central  Google Scholar 

  99. Wild M, Jungbluth P, Thelen S, Laffree Q, Gehrmann S, Betsch M, Windolf J, Hakimi M (2010) The dynamics of proximal femoral nails: a clinical comparison between PFNA and Targon PF. Orthopedics 33

  100. Xu Y, Geng D, Yang H, Wang X, Zhu G (2010) Treatment of unstable proximal femoral fractures: comparison of the proximal femoral nail antirotation and gamma nail 3. Orthopedics 33:473

    PubMed  Google Scholar 

  101. Xu YZ, Geng DC, Mao HQ, Zhu XS, Yang HL (2010) A comparison of the proximal femoral nail antirotation device and dynamic hip screw in the treatment of unstable pertrochanteric fracture. J Int Med Res 38:12661275

    Google Scholar 

  102. Yaozeng X, Dechun G, Huilin Y, Guangming Z, Xianbin W (2010) Comparative study of trochanteric fracture treated with the proximal femoral nail anti-rotation and the third generation of gamma nail. Injury 41:12341238

    Article  Google Scholar 

  103. Zeng C, Wang YR, Wei J, Gao SG, Zhang FJ, Sun ZQ, Lei GH (2012) Treatment of trochanteric fractures with proximal femoral nail antirotation or dynamic hip screw systems: a meta-analysis. J Int Med Res 40:839–851

    Article  CAS  PubMed  Google Scholar 

  104. Knobe M, Gradl G, Buecking B, Gackstatter S, Sonmez TT, Ghassemi A, Stromps JP, Prescher A, Pape HC (2015) Locked minimally invasive plating versus fourth generation nailing in the treatment of AO/OTA 31A2.2 fractures: a biomechanical comparison of PCCP((R)) and Intertan nail((R)). Injury 46:1475–1482

    Article  PubMed  Google Scholar 

  105. Kim SY, Kim YG, Hwang JK (2005) Cementless calcar-replacement hemiarthroplasty compared with intramedullary fixation of unstable intertrochanteric fractures. A prospective, randomized study. J Bone Joint Surg Am 87:2186–2192

    Article  PubMed  Google Scholar 

  106. Kim Y, Moon J, Hwang K, Choi I, Kim Y (2014) Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians. Acta Orthop Traumatol Turc 48:424–430

    Article  PubMed  Google Scholar 

  107. Stappaerts KH, Deldycke J, Broos PL, Staes FF, Rommens PM, Claes P (1995) Treatment of unstable peritrochanteric fractures in elderly patients with a compression hip screw or with the Vandeputte (VDP) endoprosthesis: a prospective randomized study. J Orthop Trauma 9:292297

    Google Scholar 

  108. Emami M, Manafi A, Hashemi B, Nemati A, Safari S (2013) Comparison of intertrochanteric fracture fixation with dynamic hip screw and bipolar hemiarthroplasty techniques. Arch Bone Joint Surg 1:14–17

    PubMed  PubMed Central  Google Scholar 

  109. Broos P, Willemsen P, Rommens P, Stappaerts K, Gruwez J (1989) Pertrochanteric fractures in elderly patients. Treatment with a longstem/long-neck endoprosthesis. Unfallchirurg 62:234–239

    Google Scholar 

  110. Broos P, Rommens P, Deleyn P, Geens V, Stappaerts K (1991) Pertrochanteric fractures in the elderly: are there indications for primary prosthetic replacement? J Orthop Trauma 5:446–451

    Article  CAS  PubMed  Google Scholar 

  111. Bonnevialle P, Saragaglia D, Ehlinger M, Tonetti J, Maisse N, Adam P, Le Gall C (2011) Trochanteric locking nail versus arthroplasty in unstable intertrochanteric fracture in patients aged over 75 years. Orthop Traumatol Surg Res 97:S95–S100

    Article  CAS  PubMed  Google Scholar 

  112. Claes H, Broos P, Stappaerts K (1985) Pertrochanteric fractures in elderly patients: treatment with Ender’s nails, blade-plate or endoprosthesis? Injury 16:261–264

    Article  CAS  PubMed  Google Scholar 

  113. Sinno K, Sakr M, Girar J, Khatib H (2010) The effectiveness of primary bipolar arthroplasty in treatment of unstable intertrochanteric fractures in elderly patients. North Am J Med Sci 2:561–568

    Article  Google Scholar 

  114. Kayali C, Agus H, Ozluk S (2006) Treatment for unstable intertrochanteric fractures in elderly patients: internal fixation versus cone hemiarthroplasty. J Orthop Surg 14:240–244

    CAS  Google Scholar 

  115. Patil A, Ansari M, Pathak A, Goregaonkar AB, Thakker CJ (2013) Role of Cemented Bipolar Hemiarthroplasty for Comminuted Inter-trochanteric Femur Fracture in elderly osteoporotic patients through a modified Transtrochanteric approach-“SION Hospital Modification”. IOSR J Dental Med Sci 9:40–47

    Article  Google Scholar 

  116. Cho S, Cho H, Cho H (2014) Primary cementless hip arthroplasty in unstable intertrochanteric femur fracture in elderlys: short-term results. Hip Pelvis 26:157–165

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedics, K.G. Hospital and Postgraduate Medical Institute, Arts College Road, Coimbatore, Tamil Nadu, 641018, India

    Senthil Nathan Sambandam & Jayadev Chandrasekharan

  2. VCU Medical Center, Ambulatory Care Center, 417 North 11th Street, Richmond, VA, USA

    Varatharaj Mounasamy

  3. Denver health Medical Center, Denver, CO, USA

    Cyril Mauffrey

Authors
  1. Senthil Nathan Sambandam
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  2. Jayadev Chandrasekharan
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  3. Varatharaj Mounasamy
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  4. Cyril Mauffrey
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Correspondence to Varatharaj Mounasamy.

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Sambandam, S.N., Chandrasekharan, J., Mounasamy, V. et al. Intertrochanteric fractures: a review of fixation methods. Eur J Orthop Surg Traumatol 26, 339–353 (2016). https://doi.org/10.1007/s00590-016-1757-z

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