Trans-Table Intraoperative Fluoroscopic Technique for Obtaining a True Lateral View of the Proximal Femur in the Lateral Decubitus Position.

Abstract

The management of proximal femoral fractures, especially comminuted subtrochanteric ones, poses a surgical challenge. It is relatively easier to perform the open reduction of these fractures in the lateral position on a standard radiolucent table, but obtaining an accurate lateral view of the femoral head and neck remains difficult. This study presents a method that overcomes the limitations of fluoroscopy in the lateral decubitus position and improves the accuracy of obtaining a true lateral view. The technique involves positioning the patient in the lateral decubitus position with the unaffected hip flexed at a 45° angle. Additionally, the C-arm is tilted 30-35° cephalad, eliminating the need for position changes or leg manipulation. This method reduces the risk of losing reduction, particularly in cases involving obese patients or complex fractures. By simplifying proximal femur fixation in the lateral decubitus position, this technique can potentially improve patient outcomes.