Correct placement of the screw or nail in trochanteric fractures. Effect of the initial placement in the migration.

This is a prospective study of 106 patients with 37 stable and 69 unstable trochanteric fractures treated with 2 different implants: a sliding screw-plate and a triflanged nail-plate. The fractures were classified according to Jensen's modification of Evans classification. The parameter migration was compared between the 2 implants and for the various areas of placement of the screw or nail within the femoral head. For stable fractures, the migration observed was independent of the area of implant placement or the type of implant used. For unstable fractures, central placement of the sliding screw resulted in a decreased mean value of migration. When the nail was used, the mean values of migration observed were independent of the areas of placement within the femoral head. In cases of central placement, the sliding screw appeared to be superior to the triflanged nail.