Reduction of lateral trochanteric fractures in external rotation

Displaced lateral trochanteric fractures require satisfactory reduction by external rotation and internal fixation with a Richard's nail plate for acceptable clinical results. In cases where the proximal fragment lies in external rotation, classic reduction procedures may accentuate displacement. External rotation of the distal fragment by temporary fixation of the proximal fragment allows all fracture fragments to move together during subsequent internal rotation and internal fixation. This paper discusses the anatomic and roentgenographic aspects of these injuries.