The unstable intertrochanteric fracture in the elderly. A technical note on valgus resection osteotomy and fixation with 150 degrees dynamic hip screw.

Valgus resection osteotomy has proven its effectiveness for the treatment of unstable intertrochanteric fractures in the elderly. A modified technique is presented, which consists in (a) resection of triangular fragments proximally and distally, (b) reduction and impaction in valgus, (c) fixation through the osteotomy site by a 150 degrees dynamic hip screw, and (d) reattachment of the greater trochanter by an 8-shaped wire cerclage. The postulated advantage is that the implant acts as an intramedullary splinting in crossing the "osteotomy" site, with minimization of implant cutting out compared with a 130 degrees angled blade plate or an I-Beam Nail Plate.