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Correspondence

TO THE EDITOR:

We read with much interest the article "Use of an Intramedullary Hip-Screw Compared with a Compression Hip-Screw with a Plate for Intertrochanteric Femoral Fractures. A Prospective, Randomized Study of One Hundred Patients" (80-A: 618–630, May 1998), by Hardy et al. We compliment the authors on an excellent study, but we do not agree with some of the techniques that were used or with the conclusion that was reached.

The technique that was used to insert the intramedullary nail is somewhat questionable. The proximal end of the femoral canal is opened, but the canal in the region of the isthmus is not reamed unless the nail jams. This technique could cause a femoral fracture, which would explain the pain in the mid-portion of the thigh that some patients have. It could also explain the cortical hypertrophy at the tip of the nail. To minimize these complications, it is . . . [Full Text of this Article]

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