J Korean Orthop Assoc.  2020 Jun;55(3):193-199. 10.4055/jkoa.2020.55.3.193.

New Approach in the Treatment of Intertrochanteric Fracture Using a Cephalomedullary Nail

  • 1Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea


A gamma nail has been used to treat intertrochanteric fractures since 1988. Although such cephalomedullary nails have mechanical advantages over extramedullary fixation devices, such as sliding hip screw, their beneficial effects on treating the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 fractures are still controversial. During their 30- year history, many problems have been overcome, and new types of cephalomedullary nails have been introduced in clinical practice. New cephalomedullary nail systems facilitate nailing procedures and enhance the purchase capability of the femoral head by a lag screw. On the other hand, the failure rate still depends on the hands of the orthopedic surgeons. This review article focused on the basic principle of medial support and restoration of a medial buttress during the treatment of trochanteric fractures using a cephalomedullary nail.


femur; intertrochanteric fracture; cephalomedullary nail; medial buttress restoration
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