Trauma, IM nailing 
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Proximal Femoral Locking Compression Plates Versus Trochanteric Nails—A New Study Designed to Provide Clear Answers Rationale for the study The plates under investigation in this study are relatively new to the market. Their novelty alone ensures that the available literature on them is rather sparse. In addition, there is a long-standing debate, whether plate fixation or intramedullary nail fixation is more appropriate for subtrochanteric fractures. This study will provide more information regarding this clinical controversy.
a
Fracture types and current methods 1. Subtrochanteric fractures There is little uniformity in the classification of subtrochanteric fractures. A comprehensive review of the English language literature revealed at least 15 different classification systems for these fractures. For the purposes of the present study it was decided to include patients with transverse fracture lines not further distal than 5 cm from the lesser trochanter. A variety of different implants is used to treat these fractures, but the treatment of choice remains controversial. In two randomized controlled trials, it could be shown that fixed angle blade plates had higher implant failure and revision rates compared to intramedullary nailing [1, 2]. Other studies that compare intramedullary nailing and plate fixation also suggest the use of intramedullary nails, but only a few significant findings underline this recommendation.
b
Nevertheless, antegrade nailing of proximal femoral fractures can lead to persistent complaints, such as residual pertrochanteric pain, stiffness, altered gait, limited walking ability, and difficulty with climbing stairs. Hip abductor weakness plays an important role in these complaints. 2. Reverse oblique fractures The reverse oblique fracture is a distinct fracture pattern; its main fracture line runs from distal-lateral to proximal-medial (below the greater trochanter to the lesser trochanter) and almost parallel with the loading force. Due to this fracture line, it is mechanically different from most intertrochanteric fractures.
c
Fig 1a–c a PF-LCP hook plate. b PF-LCP. c PFNA.
Because of the unique anatomical and mechanical characteristics of reverse oblique fractures, sliding screws do not guarantee sufficient stability. Until now, the treatment most advocated for reverse oblique fractures has been cephalomedullary nails.