ABSTRACT
Background: Intramedullary hip screw (IMHS) is a cephalomedullary nail used for surgical treatment of hip fracture for the past two decades but only a few studies have been reported. Aim of the study: To evaluate the effectiveness of IMHS for intertrochanteric fracture in Thammasat university hospital. Materials and methods: Ninety-two intertrochanteric fracture patients were retrospectively reviewed. Results: Mean operative time was 87 minutes (45-154 min) with an average blood loss of 150 ml (50- 300 ml). Intraoperative femoral shaft fracture was found in two cases which required the immediate exchange to long IMHS intraoperatively. One displaced large greater tuberosity fragment during nail insertion was treated by tension band wiring and five lateral cortex fractures were managed conservatively. Failed IMHS were found in 3 cases with two cases screw cut out the femoral head and one fracture extending from intertrochanter to the superior neck. All of these three cases were changed to hip prosthesis. Most of the patients stayed in the hospital for 3 weeks (61.4%), younger patients tend to have shorter hospital stay (<1 week) and preexisting medical complications may prolong hospitalization (>1 month). From this study, IMSH can safely treat a hip fracture patient and Sunyarn Niempoog, Sukanis Chumchuen, Chayanin Angthong, Krit Boontanapibul. Intramedullary Hip Screw (IMHS) for the Treatment of Intertrochanteric Hip Fracture: A Retrospective Study. IAIM, 2019; 6(8): 51-61. Page 52 its complications can be avoided by correct entry point, over-reaming and manually pushing the nail with use of a hammer and a centering sleeve.Conclusion: IMSH is a choice of treatment for hip fracture in Thais with a satisfactory outcome, and complications can be avoided by locating the correct entry point, over-reaming and manually push the nail while using a hammer and a centering sleeve