Multicenter retrospective cohort study (n=559, three Level I trauma centers, 2004–2010) comparing treatment failure rates — defined as periprosthetic fracture or reoperation requiring nail removal/revision — between short and long cephalomedullary nails for intertrochanteric hip fractures in patients ≥65 years.
When selecting nail length for an intertrochanteric hip fracture in a patient over 65, modern short and long cephalomedullary nails carry equivalent failure rates — reserve long nails for fracture patterns extending into the subtrochanteric region, and consider short nails in the sickest patients where shaving 19 minutes of OR time matters.
Regardless of implant choice, focus technical attention on preventing cutout: it accounts for the majority of failures and is not mitigated by nail length.
Multicenter retrospective cohort study (n=559, three Level I trauma centers, 2004–2010) comparing treatment failure rates — defined as periprosthetic fracture or reoperation requiring nail removal/revision — between short and long cephalomedullary nails for intertrochanteric hip fractures in patients ≥65 years.
When selecting nail length for an intertrochanteric hip fracture in a patient over 65, modern short and long cephalomedullary nails carry equivalent failure rates — reserve long nails for fracture patterns extending into the subtrochanteric region, and consider short nails in the sickest patients where shaving 19 minutes of OR time matters.
Regardless of implant choice, focus technical attention on preventing cutout: it accounts for the majority of failures and is not mitigated by nail length.