# HOOK ASSISTED REDUCTION IN CEPHALOMEDULLARY NAILING WITHOUT TRACTION TABLE

## TL;DR

This study shows that using a hook during femur fracture surgery improves alignment and reduces complications when a traction table is not available.

## Contribution

The study introduces a hook-assisted technique for better surgical outcomes in femoral nailing without a traction table.

## Key findings

- Group 1 had better Garden Alignment Index, collo-diaphyseal angle, and tip-apex distance compared to group 2.
- The hook-assisted technique improved anatomical reduction in displaced intertrochanteric femoral fractures.
- The method is recommended for challenging cases even when using a traction table.

## Abstract

Proximal femoral nailing for intertrochanteric femur fracture is sometimes a challenging procedure without a traction table, especially if complicated fracture pattern. We aimed to overcome this difficulty with the hook.

A retrospective study of 60 patients. 28 of the patients reduction was necessitated with a hook (group 1). The other patients did not need to use this technique (group 2, n=32). The collo-diaphyseal angle, lag screw placement, and tip-apex distance were measured using radiographs.

There were statistically significant differences between the two groups regarding the Garden Alignment Index, postoperative collo-diaphyseal angle measurements, and tip-apex distance. The Garden Alignment Index was found as 163.92 degrees (dg.) In the frontal plane in group 1, and 154.78 dg in group 2, respectively. In group 1, the tip-apex distance was 16.05 cm, whereas it was 25.32 cm in group 2. The collo-diaphyseal angle was 133.1º in group 1, and 128.65º in group 2.

The hook-assisted reduction is beneficial when operating without a traction table; however, it can also be a part of the surgeons’ equipment even when operating on a traction table. When difficulties in obtaining an ideal anatomical reduction in displaced intertrochanteric femoral fractures, we suggest using the hook-assisted reduction technique.
Level of Evidence III; Case-control Study.