title: Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails.
abstract: OBJECTIVE
  To perform a retrospective radiographic evaluation on the fracture reduction and implant position in the femoral head among patients with pertrochanteric fractures who had been treated using a cephalomedullary nail in lateral decubitus; and to assess factors that might interfere with the quality of the fracture reduction and with the implant position in using this technique.
  
  
  METHODS
  Nineteen patients with a diagnosis of pertrochanteric fractures of the femur who had been treated using cephalomedullary nails in lateral decubitus were evaluated. For outpatient radiographic evaluations, we used the anteroposterior view of the pelvis and lateral view of the side affected. We measured the cervicodiaphyseal angle, tip-apex distance (TAD), spatial position of the cephalic element in relation to the head, and the bispinal diameter. To make an anthropometric assessment, we used the body mass index. Two groups of patients were created: one in which all the criteria were normal (TAD ≤25 mm, cervicodiaphyseal angle between 130° and 135° and cephalic implant position in the femoral head in the central-central quadrant); and another group presenting alterations in some of the criteria for best prognosis.
  
  
  RESULTS
  Female patients predominated (57.9%) and the mean age was 60 years. Seven patients presented a central-central cephalic implant position. One patient present a cervicodiaphyseal angle >135° and the maximum TAD was 32 mm; consequently, 12 patients presented some altered criteria (63.2%). None of the characteristics evaluated differed between the patients with all their criteria normal and those with some altered criteria, or showed any statistically significant association among them (p > 0.05).
  
  
  CONCLUSIONS
  The technique described here enabled good reduction and good positioning of the implant, independent of the anthropometric indices and type of fracture.
authors.affiliation: Hospital Municipal Dr. Fernando Mauro Pires da Rocha, São Paulo, SP, Brazil.
authors.forename: Elton João Nunes
authors.initials: EJ
authors.lastname: de Oliveira
authors.affiliation: Hospital Municipal Dr. Fernando Mauro Pires da Rocha, São Paulo, SP, Brazil.
authors.forename: José Octávio Soares
authors.initials: JO
authors.lastname: Hungria
authors.affiliation: Hospital Municipal Dr. Fernando Mauro Pires da Rocha, São Paulo, SP, Brazil.
authors.forename: Davi Gabriel
authors.initials: DG
authors.lastname: Bellan
authors.affiliation: Hospital Municipal Dr. Fernando Mauro Pires da Rocha, São Paulo, SP, Brazil.
authors.forename: Jonas Aparecido
authors.initials: JA
authors.lastname: Borracini
keywords: Cephalomedullary nail; Femur fracture; Lateral decubitus; Pertrochanteric