A simple technique to help avoid varus malreduction of reverse oblique proximal femoral fractures

BACKGROUND Clinical guidelines from the National Institute for Health and Clinical Excellence recommend the use of an intramedullary nail for the treatment of subtrochanteric fractures.1 Reverse oblique fractures are associated with varus malunion,2 which defunctions the abductors by placing them at a mechanical disadvantage and increases the lever arm across the fracture. Most modern nails have been designed with a lateral bend to accommodate a trochanteric entry point. This simple technique helps to avoid varus malreduction without the need for excessive traction or open reduction.