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Related Experiment Video

Updated: Mar 7, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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IMHS in peritrochanteric fractures.

J Fischer1, Y Chee, M Waseem

  • 1Macclesfield District General Hospital, Macclesfield - UK.

Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
|February 23, 2017
PubMed
Summary
This summary is machine-generated.

The Intramedullary Hip Screw (IMHS) is a viable option for unstable proximal femur fractures. Careful surgical technique is crucial to avoid complications like screw cut-out, especially in revision cases.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Biomedical Engineering

Background:

  • Internal fixation of proximal femur fractures is a common surgical procedure.
  • Sliding hip screws are effective for stable fractures, but optimal implants for unstable fractures remain debated.
  • Unstable and sub-trochanteric femur fractures, especially with pathological lesions, present treatment challenges.

Purpose of the Study:

  • To evaluate the efficacy and complications of the Intramedullary Hip Screw (IMHS) for treating inter- and sub-trochanteric femur fractures.
  • To assess the impact of reduction quality and implant positioning on outcomes.
  • To analyze the performance of IMHS in both primary and revision cases.

Main Methods:

  • Retrospective review of 45 patients treated with IMHS for inter- and sub-trochanteric fractures.
  • Analysis of patient notes and radiographs focusing on reduction quality and implant position.
  • Identification and categorization of postoperative complications.

Main Results:

  • The most frequent complication was superior cut-out of the sliding screw in 8.8% of patients.
  • Varus reduction and superior screw positioning were associated with cut-out complications.
  • Two cases were revisions following failed dynamic hip screw (DHS)/dynamic condylar screw (DCS) fixation, with high failure rates in revision scenarios.

Conclusions:

  • Intramedullary Hip Screw (IMHS) fixation is a feasible treatment for unstable and pathological inter- and sub-trochanteric femur fractures.
  • Avoiding varus reduction and superior screw placement is critical for successful outcomes.
  • Revision cases using IMHS demonstrate a high rate of failure, suggesting caution in these scenarios.