Lateral imaging technique of the femoral neck in a supine-semilithotomy position without a fracture table

Abstract

Treatment of proximal femoral fractures in the supine position poses has certain challenges, especially due to difficulties in lateral imaging of the femoral neck in cases where there is no fracture table, such as prolonging the surgery time and increasing the dose of radiation exposure. The purpose of this study is to present the lateral imaging technique of the femoral neck by fluoroscopy on the conventional operating table in the treatment of proximal femoral fractures. We applied proximal femoral nail by positioning the healthy leg in a semilithotomy position to facilitate lateral imaging of the femoral neck by fluoroscopy while the patients were in the supine position. The study analyzed 22 patients (12 women, 10 men) with femoral pertrochanteric and basicervical fractures with the following types of fractures (9 patients had AO type 31-A1, 9 patients had AO type 31-A2, 4 patients had AO type 31-B2.1), and with a mean age of 62.1 years (33-75 years). The preparation time of the supine-semilithotomy position was about 2 minutes, and the reduction was finished within 9 intraoperative fluoroscopy exposure times. No patient suffered from a postoperative complication. The mean surgery time was 20 minutes (18-22 minutes), the average number of scopy shots was 8 (7-9), and the mean hospital stay duration was 2 days (2-2 days). We believe that the supine-semilithotomy technique is a suitable treatment option for proximal femoral intramedullary nailing and cannulated screw application. Since the lateral view of the femoral neck is obtained quickly and clearly with this technique, fluoroscopy does not need to be performed repeatedly, so fluoroscopy time and the number of shots are reduced, and the time spent by the patient and the surgical team in the surgery is shortened.