title: Nail Length in the Management of Intertrochanteric Fracture of the Femur.
abstract: 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.
authors.affiliation: From the Department of Orthopaedic Surgery, Geisinger Health System, Danville, PA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Horwitz
authors.forename: Akhil
authors.initials: A
authors.lastname: Tawari
authors.forename: Michael
authors.initials: M
authors.lastname: Suk
mesh_terms: D001858:Bone Nails; D000066491:Clinical Decision-Making; D004867:Equipment Design; D005270:Femur Head / Q000293:injuries* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans