Protrusion of the gliding screw into the peritrochanteric soft tissue is the result of impaction of the fracture zone. This can occur to a substantial degree during mobilisation, especially in osteoporotic bone. Lateral telescoping of the support system is essential, since a rigid implant would perforate the femoral head medially. Protrusion of the gliding screw in a lateral direction can, however, lead to considerable irritation and pain in the fascia lata area, and can severely disrupt rehabilitation, particularly for frail elderly patients.
This has been avoided by securing the support sleeve firmly in to the nail by means of a thread and by making sure that the support screw cannot slide out beyond the end of the supporting sleeve.
In this construction, the shortened lever arm of the support screw has a positive effect on the telescoping procedure. A short lever arm requires very little force to guarantee dynamisation.