Shortening of the Femoral Neck Following Peritrochanteric Fracture

Proximal femoral neck and peritrochanteric fractures are a devastating musculoskeletal injury resulting in markedly increased patient morbidity and mortality. As the annual incidence of fracture continues to increase, there is a recognized need to improve clinical outcomes following fixation, especially in peritrochanteric fractures. While many factors are associated with adverse patient outcomes, the collapse and shortening of the femoral neck that can occur during osteosynthesis of neck fractures or in surgically treated unstable peritrochanteric fractures may represent a preventable complication. Femoral neck shortening is known to decrease the moment arm of the hip abductors reducing patient function. Contemporary internal fixation devices for neck fractures allow head-neck fragments in peritrochanteric fractures to slide along/together with the implant, increasing the risk of an unlimited compression and collapse. However, the newly developed INTERTANTM intertrochanteric antegrade nail improves rotational fracture stability and allows for intraoperative interfragmentary compression, thereby reducing the erosion of the fracture surfaces between the lateral end of the neck fragment and the trochanteric region that might result in uncontrolled collapse with the risk of shortening.