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Patient Positioning for Proximal Femur Fracture Fixation: a Review of Best Practices

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Abstract

Purpose of Review

Proximal femur fractures are common traumatic injuries treated by orthopedic surgeons. Preparation and positioning for surgical intervention are critical in the proper management of proximal femur fractures. The purpose of this study was to review the current evidence on the various positioning options for patients and to highlight the principles and emerging techniques to help orthopedic surgeons treat this common injury.

Recent Findings

Strategic patient positioning is key to the reduction and fixation of proximal femur fractures without complications. The use of intramedullary devices for the fixation of proximal femur fractures has led to an increased use of the modern fracture table. The fracture table should be used when surgeons are facile with its use to avoid significant complications. Recent best available evidence has suggested increased risk of malrotation associated with the use of the fracture table. The use of the radiolucent table offers the most flexibility, but limits surgeons as multiple assistants are needed to maintain reduction during fixation.

Summary

Positioning for proximal femur fractures is an important technique for general and trauma orthopedic surgeons. Surgeons need to be aware of the various techniques for positioning of proximal femur fractures due to the diversity of injury patterns and patient characteristics. Each positioning technique has it benefits and potential complications that every orthopaedic surgeon should be familiar with while treating these injuries.

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Author information

Author notes

  1. Khushdeep S. Vig, Joseph R. Young, Eric Perloff and Cory M. Czajka contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Albany Medical Center, 43 New Scotland Road, Albany, NY, USA

    Khushdeep S. Vig, Curtis Adams, Joseph R. Young, Eric Perloff, Casey M. O’Connor & Cory M. Czajka

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  1. Khushdeep S. Vig
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  2. Curtis Adams
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  3. Joseph R. Young
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Corresponding author

Correspondence to Casey M. O’Connor.

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Conflict of Interest

KSV certifies that he had nothing of value related to this study.

CA certifies that he had nothing of value related to this study.

JRY certifies that he had nothing of value related to this study.

EP certifies that he had nothing of value related to this study.

CO certifies that he had nothing of value related to this study.

CC certifies that he had nothing of value related to this study.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects. Informed consent was not required for this study as it did not study human subjects.

Ethical review committee statement:

The study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki and has been carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act (HIPAA). This work was performed at The Albany Medical Center, Albany, NY.

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Vig, K.S., Adams, C., Young, J.R. et al. Patient Positioning for Proximal Femur Fracture Fixation: a Review of Best Practices. Curr Rev Musculoskelet Med 14, 272–281 (2021). https://doi.org/10.1007/s12178-021-09710-x

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