Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm

Graulich, Tilman; Omar, Mohamed; Sehmisch, Stephan; Liodakis, Emmanouil

doi:10.3390/jcm14072200

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Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm

¹

Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany

²

Department of Trauma, Hand and Reconstructive Surgery, Departments and Institutes of Surgery, Saarland University, 66123 Homburg, Germany

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2025, 14(7), 2200; https://doi.org/10.3390/jcm14072200

Submission received: 10 March 2025 / Revised: 19 March 2025 / Accepted: 19 March 2025 / Published: 24 March 2025

(This article belongs to the Special Issue The “Orthogeriatric Fracture Syndrome”—Issues and Perspectives)

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Abstract

Intertrochanteric fractures become more and more relevant in an aging population. Despite significant progress in the treatment of these fractures, some technical details, concerning the surgical procedure, are still a matter of strong debate. In this review of the literature, we have included the best evidence available from the last decade in an effort to shed light on some of the most controversial subjects related to intertrochanteric fractures: Treatment in the case of polytrauma or monotrauma? Reconstruction or arthroplasty? Open or closed reduction? Reconstruction with or without additional cables and plates? Cephalomedullary nail or dynamic hip screw (DHS)? Long cephalomedullary nail or short cephalomedullary nail? The results of this scoping review are controversial. By introducing a new therapeutic algorithm, we do not intend to present a new finished guideline but rather arouse a controversial debate about a relevant aspect in geriatric traumatology. These conflicting results are an indication that larger and more well-conducted, high-quality trials are needed in order to gain more secure answers.

Keywords: intertrochanteric fractures; reconstruction; arthroplasty; complication; algorithm

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MDPI and ACS Style

Graulich, T.; Omar, M.; Sehmisch, S.; Liodakis, E. Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm. J. Clin. Med. 2025, 14, 2200. https://doi.org/10.3390/jcm14072200

AMA Style

Graulich T, Omar M, Sehmisch S, Liodakis E. Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm. Journal of Clinical Medicine. 2025; 14(7):2200. https://doi.org/10.3390/jcm14072200

Chicago/Turabian Style

Graulich, Tilman, Mohamed Omar, Stephan Sehmisch, and Emmanouil Liodakis. 2025. "Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm" Journal of Clinical Medicine 14, no. 7: 2200. https://doi.org/10.3390/jcm14072200

APA Style

Graulich, T., Omar, M., Sehmisch, S., & Liodakis, E. (2025). Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm. Journal of Clinical Medicine, 14(7), 2200. https://doi.org/10.3390/jcm14072200

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Controversies in the Treatment Strategies of Intertrochanteric Fractures: A Scoping Review and Discussion of a Literature-Based Algorithm

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