[Hip osteosynthesis with IM nail: lateral decubitus without fracture table]

Area of Science:

• Orthopedic surgery
• Traumatology
• Geriatric medicine

Background:

• Hip fractures are a growing public health concern, particularly in elderly patients with osteoporosis.
• High incidence rates lead to significant healthcare costs.
• Current standard treatment involves supine positioning with a fracture table.

Purpose of the Study:

• To present a surgical technique for treating transtrochanteric hip fractures in the lateral decubitus position.
• To evaluate the feasibility and outcomes of this technique performed without a fracture table.
• To define the advantages and specific indications for this alternative surgical approach.

Main Methods:

• Surgical technique description for transtrochanteric fracture fixation using an intramedullary nail.
• Patient positioning in lateral decubitus without the use of a fracture table.
• Evaluation of operative time, blood loss, and complications.

Main Results:

• The study included eight patients (5 women, 3 men).
• Average surgical time was 67 minutes with an average blood loss of 115 cc.
• One patient experienced system detachment, resulting in a Girdlestone procedure; no neurological complications or early infections were noted.

Conclusions:

• Reduction and fixation of transtrochanteric hip fractures with an intramedullary nail in lateral decubitus without a fracture table is a viable surgical option.
• This technique demonstrates feasibility with a low incidence of associated complications.
• Further research may define precise indications and expand the use of this method.