Reduction of transtrochanteric fractures of the proximal femur without a traction table is a frequent technical challenge. This training demonstrates osteosynthesis with an intramedullary nail and the rocking maneuver, using a minimally invasive approach, in 4K video under a surgical perspective.

Training Focus

• Osteosynthesis of transtrochanteric fracture of the proximal femur
• Technique without the use of a traction table
• Surgical positioning and optimization of fluoroscopy
• Introduction of the intramedullary nail through a minimally invasive approach
• Rocking maneuver for reduction of the femoral calcar
• Strategies for controlling the positioning of the cephalic screw

Detailed Content

• Surgical Setup without a Traction Table: Patient positioning and adjustment of the “C-arm” to obtain stable anteroposterior and lateral images.
• Proximal Access and Entry Point: Precise anatomical definition to optimize the nail insertion angle.
• Guidewire Introduction and Control: Centralization within the medullary canal with dynamic verification under fluoroscopy.
• Nail Insertion Using a Minimally Invasive Technique: Canal opening and implant advancement with preservation of soft tissues.
• Rocking Maneuver for Calcar Reduction: Effective technique for correction of valgus and achievement of anatomic reduction.
• Cephalic Screw Positioning: Technical adjustments and biomechanical implications of the entry point.
• Prevention of Frequent Technical Errors: Strategies to avoid joint penetration, malalignment, and loss of stability.
• Final Outcome Assessment: Correlation between anatomic reduction, bone contact, and biomechanical strength.

Included Material

Detailed PDF: Supplementary material with a technical summary of the procedure, patient positioning criteria, surgical sequence, biomechanical principles of the rocking maneuver, critical points of the proximal access, frequent technical pitfalls, and objective criteria for evaluating the final outcome.

Improve your intraoperative decision-making and expand your technical repertoire in the treatment of proximal femoral fractures. Enroll and master the practical application of the rocking maneuver with an intramedullary nail.