title: Surgical Technique for Subtrochanteric Fracture of Femur.
abstract: A 56-year-old woman had fell over herself 4 h prior to her presentation to our hospital. The diagnosis was a subtrochanteric fracture of the right femur (AO-32-A3). The patient was placed in a supine position was set up on a fracture traction table after general anesthesia. The right leg was placed in abduction while the left leg was positioned so that there was flexion of the knee and hip joint. The C-arm was placed on the left side. The surgical field was sterilized and draped. Deformity and external rotation are always present for this type of fracture, so the first step was to place a joystick in the proximal fragment to correct the external rotation. Then the perfect entry point could be defined by K wire. After inserting guide wire into the canal dreaming was followed. An appropriate nail was selected and inserted. The distal tip of the nail should be located in the cancellous bone. Before inserting the proximal lag screws into the femoral head, the external rotation of the proximal fragment must be corrected by the joystick. The traction was loosened and the distal fragment was pushed towards the proximal side so that the gap between the fragments disappeared. The affected leg was maintained in perfect alignment. Meanwhile, the distal locking screws were inserted using the free hand perfect circle technique.
authors.affiliation: Orthopaedic Trauma Service Center, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Peng-Cheng
authors.initials: PC
authors.lastname: Wang
authors.affiliation: Orthopaedic Trauma Service Center, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Ren
authors.affiliation: Orthopaedic Trauma Service Center, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Chao-Hui
authors.initials: CH
authors.lastname: Song
authors.affiliation: Orthopaedic Trauma Service Center, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhou
mesh_terms: D001858:Bone Nails; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008875:Middle Aged
keywords: Femur; Intramedullary nail; Subtrochanteric fracture