Intramedullary Implants in Hip
Advantages
1.Ability to fix majority of fractures
2. Short surgical time and less blood loss
for unstable Intertrochanteric fractures , (no difference compare to DHS fixation for stable IT fracture
3. smaller moment arm - to bear tensile forces and lesser calcar strain
DHS - produces 1.5 times calcar strain of a normal femur
IM < 10 percent of strain
4.Better controlled collapse as bending moment at lag screw for nail is lesser than DHS .
5. Biomechanically nail construct are more stiff so more stable than DHS for torsion and bending
stress.
Disadvantages
1. Abductor injury while insertion
2. difficult revision by arthroplasty if it fails
3. anterior thigh pain due to impingement of nail tip
4. curative mismatch of nail and femora produces iatrogenic fractures
5. stress concentration at nail tip leads to fracture
6. implants are costlier .
1.Ability to fix majority of fractures
2. Short surgical time and less blood loss
for unstable Intertrochanteric fractures , (no difference compare to DHS fixation for stable IT fracture
3. smaller moment arm - to bear tensile forces and lesser calcar strain
DHS - produces 1.5 times calcar strain of a normal femur
IM < 10 percent of strain
4.Better controlled collapse as bending moment at lag screw for nail is lesser than DHS .
5. Biomechanically nail construct are more stiff so more stable than DHS for torsion and bending
stress.
Disadvantages
1. Abductor injury while insertion
2. difficult revision by arthroplasty if it fails
3. anterior thigh pain due to impingement of nail tip
4. curative mismatch of nail and femora produces iatrogenic fractures
5. stress concentration at nail tip leads to fracture
6. implants are costlier .
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