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Extracapsular Proximal Femoral Fractures (Pertrochanteric Intertrochanteric and Fractures with Reverse Obliquity)

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Fracture Reduction and Fixation Techniques


Intertrochanteric, pertrochanteric, and reverse oblique fractures belong to the extracapsular group of hip injuries. Surgical fixation of intertrochanteric fractures is based on restoring the normal alignment angle between the neck and the shaft of the femur and allowing controlled collapse in both stable and unstable fractures. For stable intertrochanteric fractures, dynamic hip screw (DHS) continues to be the most common implant of osteosynthesis used. Cephalomedullary devices are the choice of implants for pertrochanteric, reverse oblique, and in general unstable fracture patterns.

The mechanical effectiveness of internal fixation is determined by five independent variables: (a) bone quality, (b) fragment geometry, (c) quality of reduction, (d) appropriate implant selection, and (e) correct implant placement. All of these parameters are controlled by the surgeon. In this chapter, the principles of fixation of intertrochanteric, pertrochanteric, and reverse oblique fracture patterns are discussed.

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Giannoudis, P.V., Baña, E.A. (2020). Extracapsular Proximal Femoral Fractures (Pertrochanteric Intertrochanteric and Fractures with Reverse Obliquity). In: Giannoudis, P. (eds) Fracture Reduction and Fixation Techniques. Springer, Cham.

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24607-5

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