Resin type TRIPLEX, given in figure 4, has a proportion of fragmented fracture about 70%, in three pieces.
Resin type VERTEX, given in figure 5, has a proportion of fragmented fracture about 60%, in two pieces.
Although the biological and biomechanical superiority of IM nailing techniques is supported in literature in the treatment of extracapsular unstable intertrochanteric fractures, the intramedullar nailing technique is not suitable for fractures extending to the priformis fossa or for fragmented fractures
in the trochanter major, in patients with excessive anterior bowing of the femur, in patients with chest trauma or polytrauma which would contra-indicate the IM reaming procedure in terms of emboli, or in patients with a narrow (less than 8mm) IM canal.
In displaced fractures and in multiple fragmented fractures
, open reduction and internal fixation are indicated.
It was not known the swing taken, and the weight of the weapon would be important, but to cause the two fragmented fractures
would take considerable force.