The unstable intertrochanteric fracture in the elderly. A technical note on valgus resection osteotomy and fixation...

Valgus resection osteotomy has proven its effectiveness for the treatment of unstable intertrochanteric fractures in the elderly. A modified technique is presented, which consists in (a) resection of triangular fragments proximally and distally, (b) reduction and impaction in valgus, (c) fixation through the osteotomy site by a 150 degrees dynamic hip screw, and (d) reattachment of the greater trochanter by an 8-shaped wire cerclage. The postulated advantage is that the implant acts as an intramedullary splinting in crossing the "osteotomy" site, with minimization of implant cutting out compared with a 130 degrees angled blade plate or an I-Beam Nail Plate.