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Updated: Feb 26, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Accurate guide wire of lag screw placement in the intertrochanteric fractures: a technical note
Jiang Li1,2,3, Liao Wang1,2, Xiaodong Li1,2
1Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.
Abstract:
Cephalomedullary fixations are commonly used in the treatment of intertrochanteric fractures. In clinical practice, one of the difficulties is when we exit the guide wire in a wrong position of femoral neck and insert near the hole again, the guide wire often flow into the previous track. This study develops a surgical technique to direct the guide wire to slip away the previous track and slip into a right position. When guide wire is exited to the cortex of femoral, we let the wire in and out at the cortical layer for several times to enlarge the entry hole. After that, electric drill is inverted, rubbed and entered slowly at a right angle. When guide wire encountered new resistance, the electric drill is turned back instantly. This technique can help trauma and orthopedic surgeons to obtain precision placement of the lag screw after the first try is failed.

