Narrative review examining how proximal femur anatomy, fracture geometry, and implant biomechanics should guide fixation choice for intertrochanteric hip fractures. Synthesizes RCT and biomechanical data to address the unresolved clinical question of when to use a sliding hip screw versus an intramedullary device.
When you see a simple two-part pertrochanteric fracture (AO/OTA 31-A1), a sliding hip screw is appropriate and cost-effective; for everything else — unstable A2, reverse oblique, or subtrochanteric patterns — default to an intramedullary device, and always optimize reduction and nail TAD regardless of which implant you choose.
Narrative review examining how proximal femur anatomy, fracture geometry, and implant biomechanics should guide fixation choice for intertrochanteric hip fractures. Synthesizes RCT and biomechanical data to address the unresolved clinical question of when to use a sliding hip screw versus an intramedullary device.
When you see a simple two-part pertrochanteric fracture (AO/OTA 31-A1), a sliding hip screw is appropriate and cost-effective; for everything else — unstable A2, reverse oblique, or subtrochanteric patterns — default to an intramedullary device, and always optimize reduction and nail TAD regardless of which implant you choose.