New Implants for the Treatment of Intertrochanteric Femur Fractures

Surgical fixation of intertrochanteric femur fractures remains the standard of care. However, the best method of surgical fixation is debatable. Fracture fixation with a compression hip screw and side plate device has long been the gold standard, but new implant designs for intramedullary nails and even for external fixation have recently challenged compression hip screws as the best method of treatment for intertrochanteric fractures. Problems related to peri-implant fracture about first-generation short intramedullary nails used for intertrochanteric fracture have, at the very least, been significantly improved by new designs. External fixation, as a result of new advances in design of external fixation pins that reduce pin tract complications and improve pin fixation strength, has recently been shown to be a reasonable alternative treatment option. Design of compression hip screw devices also continues to evolve. Plate constructs that provide biaxial dynamic compression, lag screws with improved purchase, devices with multiple lag screws, and those designed for percutaneous insertion are among the many recent innovations to compression hip screw design. Details and comparative results of these new implants, as well as the application of injectable materials for the treatment of intertrochanteric femur fractures, are reviewed in this article.