A large number of implants have been developed for intramedullary fixation of intertrochanteric fractures. This article attempts to summarize the contemporary understanding of the existing biomechanical and clinical evidence on intramedullary nailing of intertrochanteric fractures, as to whether they should be short or long nails, and the use or not of distal locking screws. Difficulties on the translation of biomechanical findings to the clinical setting, as well as the pressing demand for standardization of the indications and the use of different modes of cephalomedullary nailing, should direct orthopaedic trauma research toward focused, well-designed clinical studies.
Level of evidence: Level V-expert opinion.