Related Experiment Video
Updated: Jan 15, 2026
04:41
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
903
Short Versus Long Nails in Treating Subtrochanteric Hip Fractures: A Systematic Review and Meta-analysis of
Amr Selim1,2,3, Nikhil Ponugoti4, Deepak Menon1,3
1Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom.
JB & JS Open Access
|October 10, 2025
Summary
Short nails for subtrochanteric hip fractures increase risks of implant failure and peri-implant fractures. Long nails demonstrate comparable rates for nonunion, infection, mortality, and reoperation, suggesting caution with short nail use.
Area of Science:
- Orthopedic surgery
- Traumatology
- Biomaterials science
Background:
- Subtrochanteric hip fractures pose significant treatment challenges due to complexity and potential complications.
- Intramedullary nailing is standard, but the choice between short and long cephalomedullary nails remains debated.
Purpose of the Study:
- To compare complication rates between short and long cephalomedullary nail fixation for subtrochanteric hip fractures.
- To evaluate implant failure, peri-implant fractures, nonunion, infection, reoperation, and mortality.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Searched PubMed, Medline, Embase, and CINAHL databases up to May 2025.
- Included 5 retrospective comparative studies (4,384 subjects) comparing short vs. long nails.
Main Results:
- Short nails showed significantly higher rates of implant failure (OR 2.12) and peri-implant fractures (OR 4.03).
- Reoperation rates were higher with short nails but not statistically significant (OR 1.33).
- No significant differences were found in nonunion, deep infection, or 1-year mortality.
Conclusions:
- Short nail use in subtrochanteric fractures is linked to increased implant failure and peri-implant fractures.
- Equivalent rates of nonunion, infection, mortality, and reoperation suggest careful consideration of short nail indications.
- Further trials are needed to define optimal short nail use criteria for subtrochanteric fractures.
