title: Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations.
abstract: OBJECTIVE
  The aim of this paper is to review the evidence relating to the anatomy of the proximal femur, the geometry of the fracture and the characteristics of implants and methods of fixation of intertrochanteric fractures of the hip.
  
  
  METHODS
  Relevant papers were identified from appropriate clinical databases and a narrative review was undertaken.
  
  
  RESULTS
  Stable, unstable, and subtrochanteric intertrochanteric fractures vary widely in their anatomical and biomechanical characteristics, as do the implants used for their fixation. The optimal choice of implant addresses the stability of the fracture and affects the outcome.
  
  
  CONCLUSIONS
  The treatment of intertrochanteric fractures of the hip has evolved along with changes in the design of the implants used to fix them, but there remains conflicting evidence to guide the choice of implant. We advocate fixation of 31A1 fractures with a sliding hip screw and all others with an intramedullary device. Cite this article: Bone Joint J 2017;99-B:128-33.
authors.affiliation: Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 800 Howard Ave, New Haven, CT 06520, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Socci
authors.affiliation: Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 800 Howard Ave, New Haven, CT 06520, USA.
authors.forename: N E
authors.initials: NE
authors.lastname: Casemyr
authors.affiliation: Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 800 Howard Ave, New Haven, CT 06520, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Leslie
authors.affiliation: Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 800 Howard Ave, New Haven, CT 06520, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Baumgaertner
mesh_terms: D001858:Bone Nails / Q000191:economics / Q000592:standards; D001860:Bone Plates / Q000191:economics / Q000592:standards*; D001863:Bone Screws / Q000191:economics / Q000592:standards*; D000069343:Bone-Implant Interface; D003362:Cost-Benefit Analysis; D005594:Fracture Fixation, Intramedullary / Q000191:economics / Q000295:instrumentation*; D006620:Hip Fractures / Q000191:economics / Q000601:surgery*; D006801:Humans; D057068:Periprosthetic Fractures / Q000209:etiology; D011474:Prosthesis Design / Q000191:economics / Q000592:standards; D016032:Randomized Controlled Trials as Topic
keywords: Hip fracture; Intertrochanteric; Pertrochanteric