With its lower complication rate in comparison with intramedullary nails, and absence of functional outcome data to the contrary, the SHS appears superior for trochanteric fractures. Further studies are required to confirm whether more recently developed designs of intramedullary nail avoid the complications of previous nails. Intramedullary nails may have advantages over fixed angle plates for subtrochanteric and some unstable trochanteric fractures, but further studies are required.
Intertrochanteric fractures of the femur: a prospective study comparing the use of the Küntscher-Y nail and a sliding hip screw.
This prospective randomized study has compared the use of the Küntscher-Y nail and a sliding hip screw in the treatment of intertrochanteric fractures of the femur. For patients whose general health was good, the use of the sliding hip screw was associated with a significantly lower 1-year mortality rate. The use of the sliding screw also resulted in a higher proportion of 1-year survivors regaining their prefracture level of mobility. There was no difference in the rates of cutting-out of the two implants but use of the Küntscher-Y nail was associated with a greater incidence of shortening.