Intramedullary Nail
A.Intramedullary fixation is the preferred treatment.
B.First-generation interlocking nails (centromedullary) are indicated when both trochanters are intact.
C.Second-generation interlocking nails with a locking screw that extends into the femoral neck (cephalomedullary) offer more stable fixation and are indicated when the lesser trochanter is displaced or comminuted.
D.Advantages
1.Potential for closed treatment with preservation of fracture hematoma and blood supply to fracture fragments
2.Decreases the moment arm on the implant compared with a lateral plate and thus decreases the tensile stress on the implant
3.Reaming the canal in preparation of the implant, which provides internal bone graft
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GREEN EARTH SURGICAL
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