Comparison of treatment options with long intramedullary nail and dynamic hip screws for metastatic subtrochanteric fracture: A cohort study

Although IMN remains essential for many pathological subtrochanteric fractures, its association with higher rates of local progression and distal canal seeding underscores the importance of careful patient selection. In appropriately selected patients, particularly those with extensive bone loss, narrow medullary canals, or elevated hemodynamic or thromboembolic risk, DHS fixation may provide a less invasive and oncologically favorable alternative with comparable functional and survival outcomes.