Reverse Obliquity Intertrochanteric Femur Fractures: Technical Tips to Avoid Failure

Reverse obliquity intertrochanteric femur fractures represent a substantial proportion of all trochanteric hip fractures. These challenging fracture patterns are unique, with their primary fracture plane from distal-lateral to proximal-medial. The use of modern cephalomedullary fixation has yielded successful results, although technical factors including avoiding malreduction and preventing collapse remain challenging. The use of adjunctive techniques including cerclage wires, colinear clamps, and mini-fragment plates can facilitate reduction efforts. The purpose of this article was to review technical tips and common pitfalls in the operative treatment of reverse obliquity intertrochanteric femur fractures.