[Progress on distal interlocking screw of cephalomedullary nail for intertrochanteric fractures]

Abstract

Objective: To summarize the progress on the distal interlocking screw of cephalomedullary nail for intertrochanteric fractures.

Methods: Related literature concerning the distal interlocking screw of cephalomedullary nail was reviewed and analyzed in terms ofbiomechanics, clinical application, operating difficulties, and complications.

Results: Distal interlocking screw can provide extra torsional stiffness in both short and long cephalomedullary nail. It is applied in most clinical cases. In long cephalomedullary nail, placing the distal interlocking screw increases the operative time for fixation and the amount of radiation exposure notably. In short cephalomedullary nail, placing the distal interlocking screw can cause adjacent vascular injury, stress concentration, and secondary fracture around the screw.

Conclusion: When the fracture is stable (type A1, type A2.1), it can be fixed solidly without the distal interlocking screw, but prefers to use a long nail. In unstable fracture, the distal interlocking screw should be used to prevent rotational displacement of the femur shaft and the failure of the nail.