Skip to main content

Advertisement

Official Journal of the Italian Society of Orthopaedics and Traumatology

Journal of Orthopaedics and Traumatology Cover Image

Use of a modified IMHS for unstable intertrochanteric fractures

Article metrics

  • 146 Accesses

  • 2 Citations

Abstract

The treatment of unstable intertrochanteric fractures in elderly osteopenic patients, especially those who cannot follow limited weight bearing instructions, is controversial. Recent publications indicate concern with excessive sliding of telescoping nail or sliding screw devices when used in these unstable intertrochanteric fractures. In our experience with the use of intramedullary hip screw (IMHS) in these fracture patterns, we have observed excessive sliding and collapse of the fracture in some patients. We modified the keyed centering sleeve by threading its internal distal third and substituted the compression screw with a custom bolt to obtain restricted sliding or rigid fixation depending on the gap between the lag screw and custom bolt. We used this modified system in static configuration to treat five patients who had an unstable intertrochanteric fracture of the femur. The length of the involved limb measured at the time of consolidation showed no shortening. In view of these results, intertrochanteric hip fractures that are unstable in patients with poor bone-stock can be fixed using the modified IMHS in a static or controlled sliding configuration.

Author information

Additional information

Received: 4 February 2002/Accepted: 18 March 2002

Rights and permissions

Reprints and Permissions

About this article

  • Key words Intertrochanteric fracture
  • Intramedullary nailing
  • Sliding