Surgical Discussion

Patient positioning:  Supine position on a fracture table, allowing for traction and manipulation of the affected limb.

Anatomical surgical approach:  A lateral approach to the proximal femur is utilized, involving an incision over the greater trochanter. The fascia lata is incised in line with the skin incision, and the vastus lateralis muscle is elevated subperiosteally to expose the lateral aspect of the proximal femur.

The fracture pattern was more complex than initially anticipated, necessitating careful open reduction under direct visualization. Traction radiographs proved invaluable in understanding the true nature of the fracture. The decision to use a reconstruction nail was influenced by the patient's potential for future high-energy impacts, providing a robust fixation option.

Postoperative protocol:   Early mobilization with toe-touch weight bearing for 6 weeks, progressing to partial weight bearing as tolerated. Emphasis on range of motion exercises and quadriceps strengthening.

Follow up:   Not specified

Orthopaedic implants used:   Reconstruction nail