HOOK ASSISTED REDUCTION IN CEPHALOMEDULLARY NAILING WITHOUT TRACTION TABLE.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery

Background:

• Proximal femoral nailing for intertrochanteric femur fractures can be challenging without a traction table, particularly with complex fracture patterns.
• Achieving ideal anatomical reduction is crucial for successful surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of a hook-assisted reduction technique in managing intertrochanteric femur fractures.
• To determine if this technique improves reduction quality and implant placement compared to standard methods.

Main Methods:

• A retrospective study of 60 patients undergoing proximal femoral nailing for intertrochanteric fractures.
• Patients were divided into two groups: 28 who required hook-assisted reduction (Group 1) and 32 who did not (Group 2).
• Radiographic parameters including collo-diaphyseal angle, lag screw placement, and tip-apex distance were analyzed.

Main Results:

• Statistically significant differences were observed in the Garden Alignment Index, postoperative collo-diaphyseal angle, and tip-apex distance between the groups.
• Group 1 (hook-assisted) showed a higher Garden Alignment Index (163.92°) and better tip-apex distance (16.05 cm) compared to Group 2 (154.78°, 25.32 cm).
• The collo-diaphyseal angle was also more favorable in Group 1 (133.1°) versus Group 2 (128.65°).

Conclusions:

• Hook-assisted reduction is a beneficial technique for intertrochanteric femur fracture treatment, particularly when a traction table is unavailable.
• The technique aids in achieving superior anatomical reduction and optimal implant positioning.
• It is recommended for surgeons facing difficulties in reducing displaced intertrochanteric femoral fractures, even with a traction table.