Retrospective study of 127 geriatric patients with unstable AO/OTA 31A2.2/2.3 pertrochanteric fractures treated with cephalomedullary nail. Introduces a three-tier classification of medial cortical support on postoperative AP radiographs — positive, neutral, and negative — and asks whether intentional superomedial displacement of the head–neck fragment (positive support) produces better mechanical and functional outcomes than anatomic or lateralized reduction.
When nailing an unstable pertrochanteric fracture, don't chase perfect anatomic medial cortex alignment — deliberately position the head–neck fragment one cortex thickness superomedial to the shaft on AP fluoroscopy.
This PMCS target gives the construct a bony backstop that limits lateral collapse during postoperative loading, translating directly into less angular and length loss and faster mobilization.
Retrospective study of 127 geriatric patients with unstable AO/OTA 31A2.2/2.3 pertrochanteric fractures treated with cephalomedullary nail. Introduces a three-tier classification of medial cortical support on postoperative AP radiographs — positive, neutral, and negative — and asks whether intentional superomedial displacement of the head–neck fragment (positive support) produces better mechanical and functional outcomes than anatomic or lateralized reduction.
When nailing an unstable pertrochanteric fracture, don't chase perfect anatomic medial cortex alignment — deliberately position the head–neck fragment one cortex thickness superomedial to the shaft on AP fluoroscopy.
This PMCS target gives the construct a bony backstop that limits lateral collapse during postoperative loading, translating directly into less angular and length loss and faster mobilization.