• Melih Unal, Yusuf Alper Kati, Muhammed Ergun, Cemil Aktan, Omer Faruk Celik, and Ferhat Guler.
• Department of Orthopedics and Traumatology, University of Health Sciences, Medical Faculty, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: meliih.unal@gmail.com.
• Injury. 2024 Apr 1; 55 (4): 111416111416.

BackgroundFemur intertrochanteric fractures are performed commonly in a supine position with a traction table. There is a challenge in obtaining traction tables, especially in low- and middle-income countries. However, there is still a debate on which position should be preferred if the traction table cannot be obtained.MethodsA total of 123 patients who were treated for femur intertrochanteric fracture (AO/OTA A1 or A2) using cephalomedullary nail (CN) were retrospectively analyzed. All three positions without traction table (supine:25 patients, semilithotomy:36 patients and lateral decubitus:62 patients) were compared according to preparation time, surgical time, Tip-Apex distance (TAD), zones of lag screw placement, collodiaphyseal angle (CDA), CDA difference (∆ CDA), postoperative posterior sag, medial cortical support and Baumgardner reduction quality criteria.ResultsThe preparation time was longer in the semilithotomy group, and surgery time was longer in the supine position group. There was no difference according to total time, surgical time, TAD, CDA difference (∆ CDA), postoperative posterior sag, medial cortical support and Baumgardner reduction quality criteria. Target lag screw placement is superior in supine and semilithotomy group than lateral decubitus.ConclusionThis study concluded that there was a difference in preparation time, surgery time and optimal lag screw placement in the lateral plane between groups. The surgeon may prefer all three methods according to patient benefit and surgeon familiarity.Copyright © 2024 Elsevier Ltd. All rights reserved.

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