Surgical Management of Hip Fractures: An Evidence-based Review of the Literature. II: Intertrochanteric Fractures

J Am Acad Orthop Surg, Vol 16, No 11, November 2008 Kevin Kaplan, MD, Ryan Miyamoto, MD, Brett R. Levine, MD, Kenneth A. Egol, MD and Joseph D. Zuckerman, MD

Treatment of intertrochanteric hip fracture is based on patient medical condition, preexisting degenerative arthritis, bone quality, and the biomechanics of the fracture configuration. A critical review of the evidence-based literature demonstrates a preference for surgical fixation in patients who are medically stable. Stable fractures can be successfully treated with plate-and-screw implants and with intramedullary devices. Although unstable fractures may theoretically benefit from load-sharing intramedullary implants, this result has not been demonstrated in the current evidence-based literature.