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Peer-reviewedCC BY 4.0Cureus

Reverse Obliquity Intertrochanteric Hip Fractures: A Technique Guide for Using a Blocking Screw to Enhance Fixation

  • Nathan Forren1
  • Daniel Sabo1
  • Brent Whitehead1
  • Vincenzo Gentile2
  • Adam Hoffman3
  • Tyson Schrickel3
  • John V Gentile3
  1. 1Department of Orthopedic Surgery, St. Elizabeth Youngstown Hospital, Youngstown, USA
  2. 2Department of Medicine, Heritage College of Osteopathic Medicine, Ohio University, Warrensville Heights, USA
  3. 3Department of Orthopedic Trauma, St. Elizabeth Youngstown Hospital, Youngstown, USA
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Abstract

Reverse oblique (RO) intertrochanteric (IT) femur fractures are an unstable fracture variant because of loss of lateral-wall support, making cephalomedullary nail (CMN) fixation the preferred implant strategy for these fractures. Despite the biomechanical advantages of CMNs, lateral migration of the nail within the canal may permit fracture shear during weight-bearing and contribute to loss of reduction or fixation failure. The technique discussed in this article describes using a blocking screw in RO IT hip fractures to limit potential lateralization of the nail in the distal aspect of the proximal femoral canal and neutralize this shear tendency. The screw is placed adjacent to the intramedullary nail to support maintenance of reduction and alignment. This technical guide describes the operative steps and considerations for selective use of the screw; it does not present clinical or biomechanical outcome data. Further study is needed to determine its effect on fracture healing and fixation stability.

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Cite

BibTeXRIS
BibTeX
@article{forren2026reverse,
  title = {{Reverse Obliquity Intertrochanteric Hip Fractures: A Technique Guide for Using a Blocking Screw to Enhance Fixation}},
  author = {Nathan Forren and Daniel Sabo and Brent Whitehead and Vincenzo Gentile and Adam Hoffman and Tyson Schrickel and John V Gentile},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.117493},
  url = {https://doi.org/10.7759/cureus.117493},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Reverse Obliquity Intertrochanteric Hip Fractures: A Technique Guide for Using a Blocking Screw to Enhance Fixation
AU  - Nathan Forren
AU  - Daniel Sabo
AU  - Brent Whitehead
AU  - Vincenzo Gentile
AU  - Adam Hoffman
AU  - Tyson Schrickel
AU  - John V Gentile
PY  - 2026
DA  - 2026/10/05
JO  - Cureus
DO  - 10.7759/cureus.117493
UR  - https://doi.org/10.7759/cureus.117493
AB  - Reverse oblique (RO) intertrochanteric (IT) femur fractures are an unstable fracture variant because of loss of lateral-wall support, making cephalomedullary nail (CMN) fixation the preferred implant strategy for these fractures. Despite the biomechanical advantages of CMNs, lateral migration of the nail within the canal may permit fracture shear during weight-bearing and contribute to loss of reduction or fixation failure. The technique discussed in this article describes using a blocking screw in RO IT hip fractures to limit potential lateralization of the nail in the distal aspect of the proximal femoral canal and neutralize this shear tendency. The screw is placed adjacent to the intramedullary nail to support maintenance of reduction and alignment. This technical guide describes the operative steps and considerations for selective use of the screw; it does not present clinical or biomechanical outcome data. Further study is needed to determine its effect on fracture healing and fixation stability.
SN  - 2168-8184
ER  -