Preventing Wedge Deformities When Treating Intertrochanteric Femur Fractures with Intramedullary Devices: A Technical Tip

Bennet A. Butler, Ryan S. Selley, Hobie D. Summers, Michael D. Stover*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Intertrochanteric femur fractures are common injuries associated with significant patient morbidity and mortality and high societal costs. Although intramedullary devices have shown promises for treating a wide range of intertrochanteric femur fractures, improper technique can lead to malalignment, fracture displacement, and/or iatrogenic fractures. In particular, a "wedge effect" has been described, in which the passage of conical reamers and the intramedullary nail itself results in the distraction of intertrochanteric fragments with lateralization of the shaft from the femoral neck and varus malalignment. Here, we describe the mechanism by which this deformity is generated and describe techniques for preventing it, including the use of a modified starting point and an alternative to the conical opening reamers.

Original languageEnglish (US)
Pages (from-to)e112-e116
JournalJournal of orthopaedic trauma
Volume32
Issue number3
DOIs
StatePublished - Mar 1 2018

Keywords

  • intertrochanteric femur fracture
  • intramedullary nailing
  • malunion

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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