Embedding the lateral end of the lag screw within the lateral wall in the repair of reverse obliquity intertrochanteric femur fracture

OBJECTIVE: The management of reverse oblique intertrochanteric femoral fractures is difficult because such fractures have unique biomechanical characteristics. This study was performed to review the results of treating reverse oblique intertrochanteric femoral fractures with a long cephalomedullary nail by embedding the lateral end of the lag screw to secure axial compression. METHODS: We herein report the surgical outcomes in seven patients with reverse oblique intertrochanteric fractures treated with our procedure. Patients whose hip screws obviously had no contact with the distal fragment and whose follow-up time was too short were excluded. The lateral end of the lag screw was embedded within the lateral cortex, and the screws were locked to the nail. All nails were long, and a distal locking screw was inserted in the dynamized position. RESULTS: No reoperation, definite leg length discrepancy, or malunion occurred in this study. CONCLUSIONS: These data suggest that early complications do not seem to increase when the lateral end of the lag screw is embedded and the screw is locked to the nail in the treatment of reverse oblique intertrochanteric fracture at this stage.