Preventing the Slide in High-Energy Intertrochanteric Fractures With Intramedullary Nails

Summary:Intramedullary nailing is the gold standard treatment for high-energy intertrochanteric femur fractures. Despite being associated with higher union and lower complication rates, it is not uncommon to see the proximal head and neck fragment "slide"and result in a shortened femoral neck and/or prominent cephalomedullary screws laterally. This type of subsidence in alignment can ultimately lead to suboptimal patient outcomes. In an effort to reduce this effect, surgeons should be able to identify preventable factors, as well as incorporate novel surgical techniques, to reduce the potential for malreduction and consequential "slide."Level of Evidence:Therapeutic Level V.