Fig. 1
Simple radiograph of total hip anteroposterior (AP) (A), left femur AP (B), and lateral (C), intertrochanteric femoral fracture AO Foundation/Orthopaedic Trauma Association classification 31-A2 fracture in the left femur with anterolateral bowing and complete union of a previous atypical diaphyseal fracture. A decrease in bone density in the lateral cortex of the femur and pull-out of the distal screw of the compression plate can be found in the left femur AP and lateral (B, C).

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Fig. 2
(A) In the C-arm image intensifier image, stable reduction of a trochanteric fracture was achieved. (B) Three screws inserted in the proximal hole of the compression plate, which can be interrupted for insertion of the proximal femoral nail, were removed. (C) A compression hip nail was inserted successfully without interrupting previously inserted elastic nails. (D) A guidewire for the femoral head lag screw was inserted.

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Fig. 3
(A) In the C-arm image intensifier image, a guidewire for the femoral head lag screw was inserted in the center-center position of the femoral head and fixed primarily. (B) A distal screw was inserted, achieving simultaneous fixation of compression plate and compression hip nail. (C) After reaming the femoral head, the lag screw of the femoral head was inserted. (D) For the three screws removed in the proximal compression plate, an additional screw was inserted for the most distal hole, and AO cable wiring was performed for two proximal removed screw holes.

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Fig. 4
In the postoperative simple radiograph, successful reduction of the femoral trochanteric fracture can be found in the total hip anteroposterior (AP) (A), left femur AP (B), and lateral (C).

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Fig. 5
Sixteen months after the operation, complete union of the femoral trochanteric fracture can be found in the total hip anteroposterior (AP) (A), left femur AP (B), and lateral (C).

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