Introduction:

Unstable trochanteric fractures show difficulty in achieving stable osteosynthesis, early support and rapid social reintegration. They are treated by intra or extramedullary osteosynthesis, the later, by using a static or dynamic screw plate. Intramedullary implants have sliding nails or screws.

Objective:

To review the literature published from 2015 and 2020 that compares the different methods of surgical fixation of unstable trochanteric fractures.

Search strategy:

We searched in PubMed for publications from 2010 to 2020 in English with the terms “unstable trochanteric fractures”, “treatment of extracapsular fractures of the proximal femur”, “osteosynthesis in unstable femoral trochanteric fractures”.

Conclusions:

Unstable trochanteric fractures have a tendency to varus displacement with medialization of the diaphysis. The static nail-plate shows high failure rates, higher than that of the sliding nail-plate (DHS), but the trochanteric stabilizing plate (TSP) seems to be the best implant for extramedullary osteosynthesis, which is very similar to that reported with intramedullary implants.

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