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Controversies in Intramedullary Fixation for Intertrochanteric Hip Fractures

Baldwin, Paul C. III MD; Lavender, Randy C. MD; Sanders, Roy MD; Koval, Kenneth J. MD

doi: 10.1097/BOT.0000000000000652

Intertrochanteric hip fractures are common and costly. Intramedullary fixation has gained popularity as a means of stabilizing intertrochanteric hip fractures. This review article presents some of the controversies surrounding the treatment of intertrochanteric fractures using a cephalomedullary nail. These topics include nail length, the need for distal interlocking, proximal screw design, the number of proximal lag screws, and integrated proximal sliding lag screws.

Level of Evidence: Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.

*Department of Orthopaedic Surgery, Orlando Regional Medical Center, Orlando Health, Orlando, FL; and

Florida Orthopaedic Institute, Department of Orthopaedic Surgery, University of South Florida, Tampa, FL.

Reprints: Kenneth J. Koval, MD, Department of Orthopaedic Surgery, Level One Orthopaedics, Orlando Regional Medical Center, Orlando Health, 1222 South Orange Avenue, Orlando, FL 32806 (e-mail:

K.J. Koval receives royalties from Zimmer Biomet and Newclip; R. Sanders receives royalties from Zimmer Biomet, Stryker, Smith & Nephew. For the remaining authors none were declared.

Accepted July 01, 2016

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