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Lateral Positioning for Proximal Femoral Nailing of the Intertrochanteric Fracture: Surgical Technique
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Kwan Hee Lee, Hoon Jeong, Jong Kyoung Ha, Yong Ju Kim, Won Hee Jang
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J Korean Fract Soc 2011;24(1):79-82. Published online January 31, 2011
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DOI: https://doi.org/10.12671/jkfs.2011.24.1.79
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 Abstract
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- In the treatment of intertrochanteric fractures, most of intramedullary nailings are performed on a fracture table in supine position. In supine position, however, soft tissue mass of the patients and drapes make it difficult to access to the piriformis fossa and to straighten the trajectory of reamer and nail insertion. To resolve these problems, we have treated twenty intertrochanteric fractures in lateral position on the general operation table with IM nail. Adjustment of the position of lag screw in femoral head was done with the technique that overlaps the shadows of the femoral head, nail and targeting guide in the lateral view. Because the entire injured limb can be moved readily, it was easy to reduce fracture and to convert to open procedure. In cases likely that the fracture table is unavailable in which patients are obese, have short stature or are amputated, and that open procedure is strongly likelihood, lateral position will be helpful technique in the treatment of intertrochanteric fractures with IM nail.
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Citations
Citations to this article as recorded by  - Outcomes of Internal Fixation with Compression Hip Screws in Lateral Decubitus Position for Treatment of Femoral Intertrochanteric Fractures
Cheon-Gon Park, Taek-Rim Yoon, Kyung-Soon Park
Hip & Pelvis.2018; 30(4): 254. CrossRef - The Effects of Sa-Am Spleen-tonifying Acupuncture on Radial Pulse in Healthy Human Subjects
Kwang Sik Yoon, Hyun Lee
The Acupuncture.2013; 30(4): 1. CrossRef
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Inferior Subluxation of Humeral of Head after Surgery for Fracture of Proximal Humerus
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Jun Gyu Moon, Hyok Woo Nam, Jong Oh Kim, Jong Kyoung Ha, Seok Bae Ryu
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J Korean Fract Soc 2005;18(1):43-47. Published online January 31, 2005
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DOI: https://doi.org/10.12671/jkfs.2005.18.1.43
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Abstract
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- PURPOSE
To study the development of inferior shoulder subluxation after surgery for proximal humerus fractures. To analyze the mechanism development of such subluxation and the association between different types of proximal humerus fractures, quality of reduction achieved the method of operation performed.
MATERIALS AND METHODS
A retrospective analysis of 45 proximal humerus fractures that were treated by surgery between March 1997 and July 2002 was done. All patients had a minimum of 12 months of postoperative follow up. Preoperative radiographs were classified by the Neer's classification. Different operative treatment methods, post reduction alignment and the degree of postoperative subluxation if present, were analysed. In order to evaluate effect of loss of negative intraarticular pressure, we compared this series with 15 cases of recurrent shoulder dislocation treated by open Bankart operation.
RESULTS
13 patients out of 45 (29%) developed immediate postoperative inferior shoulder subluxation. 3-part fractures of the proximal humerus showed a higher incidence of the same than the 2-part types. The better reduced fractures had lesser rates of subluxation. Open reduction (39%, 11 patients) results in an increased incidence of inferior subluxation than closed methods of reduction (13%, 2 patients).
CONCLUSION
Inferior subluxation of the humeral head after surgery for the proximal humerus fracture can occur and persist till postoperative period of 2 months. Deltoid muscle tone affected by shortening of humeral neck plays an important role. Early active exercise for restoration deltoid tone may be effective in prevention of inferior subluxation.
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Citations
Citations to this article as recorded by - Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report
Samuel Baek, Geum-Ho Lee, Myung Ho Shin, Tae Min Kim, Kyung-Soo Oh, Seok Won Chung
Clinics in Shoulder and Elbow.2023; 26(3): 302. CrossRef
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