Reverse Obliquity Intertrochanteric Femur Fractures: Technical Tips to Avoid Failure

Abstract

Summary: Reverse obliquity intertrochanteric femur fractures represent a substantial proportion of all trochanteric hip fractures. These challenging fracture patterns are unique, with their primary fracture plane from distal-lateral to proximal-medial. The use of modern cephalomedullary fixation has yielded successful results, although technical factors including avoiding malreduction and preventing collapse remain challenging. The use of adjunctive techniques including cerclage wires, colinear clamps, and mini-fragment plates can facilitate reduction efforts. The purpose of this article was to review technical tips and common pitfalls in the operative treatment of reverse obliquity intertrochanteric femur fractures.

Comparative study of a novel proximal femoral bionic nail and three conventional cephalomedullary nails for reverse obliquity intertrochanteric fractures: a finite element analysis

“…Reverse obliquity intertrochanteric (ROI) fractures, categorized as OTA/AO 31-A3, represent 2%–23% of trochanteric hip fractures ( Haidukewych et al, 2001 ; Makki et al, 2015 ; Sekimura et al, 2023 ). These fractures, identified by a fracture line running from distal-lateral to proximal-medial, present a substantial orthopedic challenge owing to their unique anatomical and mechanical characteristics ( Haidukewych et al, 2001 ).…”

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“…Reverse obliquity intertrochanteric (ROI) fractures, categorized as OTA/AO 31-A3, represent 2%-23% of trochanteric hip fractures (Haidukewych et al, 2001;Makki et al, 2015;Sekimura et al, 2023). These fractures, identified by a fracture line running from distallateral to proximal-medial, present a substantial orthopedic challenge owing to their unique anatomical and mechanical characteristics (Haidukewych et al, 2001).…”