How to Assess Proximal Femoral Shortening after Nailing of Proximal Femoral Fractures? A Short Review

Abstract

Proximal femoral fractures (PFFs) are considered one of the most frequent situations faced by orthopaedic surgeons. Many lines of management had been described. Although management of PFFs with cephalomedullary nails (CMNs) is now considered the gold standard with many mechanical and biological advantages, this technique may have some disadvantages such as residual peritrochanteric pain, limping, limited walking distance, and difficulty with stairs. These complications may be attributed to fracture malreduction with shortening, which may result in either malunion or nonunion and ultimately implant failure. The resultant proximal femoral shortening (PFS) with alteration of the proximal femoral mechanics may affect both the hip abductor function and the daily patient activities. The purpose of this short review is to discuss the assessment and secondary effects of PFS after treating femoral fractures with CMNs.