Intertrochanteric Hip Fracture: Intramedullary Nails

The incidence of intertrochanteric hip fractures is expected to increase worldwide. Evidence-based approaches to treatment strategies, and surrounding support and aftercare structures, are needed to reduce morbidity and mortality in the increasingly aging and comorbid fracture population. In this chapter, relevant anatomy, biomechanics, and classification systems to determine fracture stability and consequent osteosynthetic treatment, as well as peri-operative management, are discussed. Adequate stability assessment is the key to determine the necessity for intramedullary nailing as compared to extramedullary fixation. Pearls and pitfalls of the surgical process of intramedullary nailing for intertrochanteric femur fractures are discussed, and common complications are shown. Evidence-based medical and anesthesiological management strategies during the pre-, peri-, and post-operative treatment period, as well as aftercare principals, are described.