Proximal femoral nailing in lateral decubitus position

Proximal femoral nailing in supine position using traction table

different positions of the patient during the surgery

Optimum Tip-to-apex distance (TAD) is 25mm or less.

• Normal femoral neck shaft angle between 125 and 145 degree.

• The Baumgartner reduction quality criteria : -

  1. Criterion one (alignment) :

     1. Anterior posterior view : normal or slight valgus neck shaft angle
     2. lateral view : less than 20 degree of angulation (Slight valgus means a valgus of no more 10 degrees)

  2. Criterion two (displacement) :

     1. Anterior posterior view: less than 4 mm of displacement of any fragment.
     2. Lateral view: less than 4 mm of displacement of any fragment.

  3. The reduction will be categorized as good if both criteria were met, acceptable if only one criterion was met, and poor if Neither criterion was met.

The fluoroscopic exposure time is defined as: The total duration of fluoroscopy use in minutes during the set up and the surgical procedure.

The period between the moment of transfer of the patient from the anesthesia team to the surgical team till the time of incision. This period includes placement of the patient on the surgical table or the traction table, preparation, and draping. The reduction and use of fluoroscopy during the reduction will be included within this time frame.