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Related Experiment Video

Updated: Jan 8, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
04:41

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner

Published on: June 6, 2025

797

Intertrochanteric Nailing Without a Traction Table: A Practical Positioning Technique on a Standard Operating Table.

Kamil Balaban1

  • 1Orthopedics and Traumatology, Ministry of Health Finike State Hospital, Antalya, TUR.

Cureus
|December 15, 2025
PubMed
Summary

This study presents a novel technique for intertrochanteric femur fracture fixation using cephalomedullary nailing without a traction table. The method ensures safe and reproducible intramedullary fixation, even in resource-limited settings.

Keywords:
intertrochanteric fractureintertrochanteric hip fractureintramedullary nailingoperating roomsoperating theatrepatient positioning

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Medical Device Innovation

Background:

  • Intertrochanteric femur fractures are common and typically treated with cephalomedullary nailing.
  • Traction tables are standard for this procedure but are unavailable in many resource-limited settings.
  • Lack of specialized equipment hinders effective fracture fixation in underserved areas.

Purpose of the Study:

  • To introduce a novel, equipment-independent positioning method for intramedullary fixation of intertrochanteric femur fractures.
  • To provide practical guidance for surgeons operating without traction tables.
  • To enhance surgical workflow and imaging quality in resource-constrained environments.

Main Methods:

  • Utilized a standard radiolucent operating table with a central post.
  • Employed caudal table translation, ipsilateral sacral elevation (15-20°), and contralateral limb lowering (40-50°).
  • Achieved adequate anteroposterior and lateral fluoroscopic views without specialized traction equipment.

Main Results:

  • Demonstrated a safe and reproducible method for intramedullary fixation.
  • Enabled adequate fluoroscopic visualization comparable to standard techniques.
  • Offered improved ergonomics and workflow efficiency for surgeons.

Conclusions:

  • The described positioning technique offers a practical alternative for cephalomedullary nailing in centers lacking traction tables.
  • This method expands operative feasibility for treating intertrochanteric femur fractures in equipment-constrained settings.
  • Proper preparation can mitigate potential challenges like limited leg support and contamination risks.