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 .

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