Key result
Hook-assisted reduction without a traction table is linked to ~37% shorter tip-apex distance during femoral nailing.
Why the study?
Proximal femoral nailing for intertrochanteric femur fracture without a traction table can be challenging, especially in complicated fracture patterns, prompting evaluation of a hook-assisted reduction technique.
Does hook-assisted reduction improve radiographic alignment in patients undergoing proximal femoral nailing for intertrochanteric femur fracture without a traction table?
Case-Control (n=60)
Does hook-assisted reduction improve radiographic alignment in patients undergoing proximal femoral nailing for intertrochanteric femur fracture without a traction table?
Hook-assisted reduction improves radiographic alignment during proximal femoral nailing for intertrochanteric femur fractures when operating without a traction table.
May support hook-assisted reduction for alignment in traction-free nailing; hypothesis-generating pending randomized trials.
Introduction: Proximal femoral nailing for intertrochanteric femur fracture is sometimes a challenging procedure without a traction table, especially if complicated fracture pattern. We aimed to overcome this difficulty with the hook. Materials and Methods: A retrospective study of 60 patients. 28 of the patients reduction was necessitated with a hook (group 1). The other patients did not need to use this technique (group 2, n=32). The collo-diaphyseal angle, lag screw placement, and tip-apex distance were measured using radiographs. Results: There were statistically significant differences between the two groups regarding the Garden Alignment Index, postoperative collo-diaphyseal angle measurements, and tip-apex distance. The Garden Alignment Index was found as 163.92 degrees (dg.) In the frontal plane in group 1, and 154.78 dg in group 2, respectively. In group 1, the tip-apex distance was 16.05 cm, whereas it was 25.32 cm in group 2. The collo-diaphyseal angle was 133.1º in group 1, and 128.65º in group 2. Conclusions: The hook-assisted reduction is beneficial when operating without a traction table; however, it can also be a part of the surgeons’ equipment even when operating on a traction table. When difficulties in obtaining an ideal anatomical reduction in displaced intertrochanteric femoral fractures, we suggest using the hook-assisted reduction technique. Level of Evidence III; Case-control Study.
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Tekin et al. (2024) conducted a case-control in Intertrochanteric femur fracture (n=60). Hook-assisted reduction vs. No hook assistance was evaluated on Garden Alignment Index, postoperative collo-diaphyseal angle, and tip-apex distance. Hook-assisted reduction during proximal femoral nailing without a traction table significantly improved tip-apex distance (16.05 vs 25.32 cm) and collo-diaphyseal angle (133.1º vs 128.65º).
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