To synthesize evidence between tip apex distance and screw cut-out after fixation of proximal femur fractures by dynamic hip screw or intra medullary nail. Methods: A retrospective cohort study of one hundred and six patients from January 2021 till December 2021. Patients who had fracture proximal femur managed using a dynamic hip screw or intramedullary nail were included in this study. A minimum of six months follow up in mandatory for including patients as well. We excluded patients who had fracture proximal femur managed by other modality. Three patients complicated with screw cut-out, and required conversion to hemiarthroplasty, while one patient had a fall and experienced a fracture required plate fixation. One patient converted to total hip replacement due to non-union. The tip apex distance of the failed patients were (32, 30, and 33) Two were fixed by Dynamic hip screw (DHS) while one was fixed by Proximal femoral nail (PFN). Tip Apex Distance is a reliable indicator for predicting screw cutting in intertrochanteric fractures treated with Dynamic Hip Screw or Proximal femoral nail.

Keywords : Dynamic hip screw; Intramedullary nail; Fracture proximal femur; Tip apex distance; Screw cut-out.