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Evidence to Improve Care

5

Surgery for Subtrochanteric or Unstable Intertrochanteric Fractures

Patients diagnosed with a subtrochanteric fracture or unstable intertrochanteric fracture are treated surgically with intramedullary nails.


Lower complication rates are associated with the use of intramedullary nails versus sliding hip screws in the treatment of subtrochanteric and unstable intertrochanteric fractures. When used to treat subtrochanteric fractures, intramedullary nails have been shown to result in fewer cases of fracture fixation failure than sliding hip screws. Further, the use of intramedullary nails in surgery for unstable intertrochanteric fractures has been shown to result in improved mobility and decreased limb shortening when compared to sliding hip screws.

For Patients

Your surgeon should explain which type of surgery is most appropriate for your type of hip fracture.


For Clinicians

If your patient has a subtrochanteric fracture, use intramedullary nails. If your patient was ambulatory before their hip fracture and has an unstable intertrochanteric fracture, use intramedullary nails. If your patient was not ambulatory before their hip fracture and has an unstable intertrochanteric fracture, use a sliding hip screw.


For Health Services

Ensure that surgeons have access to all resources necessary to perform appropriately selected procedures.

Process Indicator

Percentage of patients diagnosed with a subtrochanteric or unstable intertrochanteric fracture who are treated with intramedullary nails

  • Denominator: total number of adults diagnosed with either a subtrochanteric fracture or an unstable intertrochanteric fracture who undergo surgery

  • Numerator: number of people in the denominator who receive intramedullary nails

  • Data source: Discharge Abstract Database, local data collection

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