J Korean Fract Soc.  2009 Jan;22(1):66-70. 10.12671/jkfs.2009.22.1.66.

Correction of Malalignment during Subtrochanteric Nailing

• Yang KH

• KMID: 2183890
• DOI: http://doi.org/10.12671/jkfs.2009.22.1.66

Abstract

No abstract available.

MeSH Terms

Nails

Figure

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  Fig. 1 Nail insertion with uncorrected external rotation and flexion displacement of the proximal fragment results in varus and flexion deformity.

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  Fig. 2 Malalignment correction is performed by insertion and elevation of a long tonsil hemostat from lateral aspect of the proximal thigh.

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  Fig. 3 External rotation and abduction deformity of the proximal fragment is corrected by elevating the handle of the forceps toward the anterior aspect of the thigh using a curved tip placed at the lesser trochanter as a fulcrum, which is followed by advancing a straight guide wire through the proper entry point.

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  Fig. 4 Flexion deformity (C) of the proximal fragment that remained even after correction of external rotation deformity with one hemostatic forceps (A, B), is further corrected by placing additional forceps more distal to the previously inserted forceps in a similar manner, finally followed by advancing a straight guide wire in a well reduced position (D).

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  Fig. 5 Both hemostatic forceps are maintained in place (A) until the lag screw guide pin is placed in the proper position of the femoral head (C, D) to prevent recurrence of flexion deformity. With the distal interlocking holes circular (arrow) and posterior margins of both femoral condyles exactly overlapped in the lateral view (B), nail geometry can be used to get a correct rotational alignment (femoral anteversion of 15° in this case).

Reference

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