The treatment of unstable proximal femur fractures in elderly patients presents a significant technical challenge, often complicating the proper execution of the surgical procedure. This training offers a practical immersion in proximal femur osteosynthesis with an intramedullary nail, presenting an optimized approach that includes positioning without a traction table and the "seesaw" maneuver, all detailed in a high-resolution video from a surgical perspective to facilitate replication.

Training Focus:

• Osteosynthesis of unstable proximal femur fractures with an intramedullary nail.
• Patient positioning technique without a traction table.
• "Seesaw" reduction maneuver for impacted and valgus fractures.
• Management of guidewire insertion and intramedullary canal opening.

Detailed Content:

• Positioning Without Traction: Methodology for patient positioning, including the use of a gynecological leg holder for the contralateral limb, optimizing the surgical field and radioscopic visualization.
• Precise Guidewire Insertion: Protocols for creating the entry portal aligned with the anterior superior iliac spine, shaping the guidewire for a better angle of attack, and radiological verification for centralization and prevention of obliquity.
• Safe Intramedullary Canal Opening: Technique for using the soft tissue guide/protector, directing it medially to protect the lateral femoral cortex during reaming.
• Short Intramedullary Nail: Systematic approach to nail insertion and guidewire removal, considering the challenges of impaction and valgus deviation.
• "Seesaw" Reduction Maneuver: Demonstration of the reduction technique for valgus or impacted proximal fragments, including the creation of a safe mini-portal and the application of leverage to obtain and maintain anatomical reduction with minimal manipulation.
• Definitive Fixation: Sequence for guidewire and sliding screw introduction, strategic positioning of the locking screw (with adjustment for piston effect), and insertion of the distal locking screw, ensuring stability.
• Minimization of Access and Tissue Trauma: Strategies for performing the procedure with reduced entry portals, promoting a minimally invasive character and favoring early patient mobility.

Included Material:

• Detailed PDF: A guide summarizing the principles of osteosynthesis of unstable proximal femur fractures with an intramedullary nail, the methodology of positioning without a traction table, the steps for precise guidewire insertion, and a detailed description of the "seesaw" reduction maneuver, as well as a practical guide for definitive fixation.

Enhance your skills in orthopedic trauma surgery. Enroll now and master the techniques of proximal femur osteosynthesis with an intramedullary nail and the seesaw maneuver, optimizing your surgical outcomes and patient recovery.