title: Fixation of intertrochanteric femur fractures using Proximal Femoral Nail Antirotation (PFNA) in the lateral decubitus position without a traction table.
abstract: OBJECTIVE
  The aim of this study was to evaluate whether intertrochanteric femur fractures can be reduced and nailed properly in the lateral decubitus position using Proximal Femoral Nail Antirotation (PFNA) as a fixation device without the use of a traction table.
  
  
  METHODS
  The study included 207 patients (81 male and 126 female; mean age: 75 years, range: 22 to 95 years). According to the Evans classification, there were 7 Type 1, 40 Type 2, 33 Type 3, 38 Type 4, 61 Type 5 and 28 reverse oblique fractures. Radiographs were used to measure the tip-apex distance (TAD), the quadrant of the helical blade according to Cleveland and Bosworth, Ikuta's reduction subgroup, collodiaphyseal angle and reduction gaps postoperatively.
  
  
  RESULTS
  Mean follow-up time was 20.4 (range: 6 to 38) months. According to Ikuta's classification, 176 (85%) reduced fractures were of subtype N, 15 (7.2%) subtype P and 16 (7.7%) subtype A. Good or acceptable reduction according to the Herman criteria was obtained in 99% of fractures. Mean TAD was 29.2 millimeters. Mean operation time was 57.2 minutes. Optimal blade position (center-center or inferior-center) was achieved in 53.5% of patients and was in the superior-posterior quadrants in only 2.4% of patients. Cut-out complication occurred in 9 patients (4.3%).
  
  
  CONCLUSIONS
  While the nailing of intertrochanteric fractures in a lateral decubitus position does not provide ideal quadrant placement and TAD, results are encouraging probably due to the excellent stability that is provided by PFNA.
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey. draliturgutort@yahoo.com.tr.
authors.forename: Ali
authors.initials: A
authors.lastname: Turgut
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.
authors.forename: Önder
authors.initials: Ö
authors.lastname: Kalenderer
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Günaydın
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Önvural
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Karapınar
authors.affiliation: Tepecik Training and Research Hospital, Department of Orthopedics and Traumatology, Izmir, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Ağuş
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D012399:Rotation; D013997:Time Factors; D014143:Traction; D016896:Treatment Outcome