Lateral Decubitus vs Traction in the Supine Position in Proximal Femoral Nailing. Is There a Huge Difference?

Proximal Femoral Nailing in Unstable Intertrochanteric Fractures: Lateral Decubitus Position Versus Supine Position on Traction Table.

This study is designed to compare two positions in the management of unstable intertrochanteric femur fractures. It's to compare the traditional supine position using a traction table and lateral decubitus. This study is designed to Compare between The accuracy of reduction In both methods, in addition,the radiological exposure and other secondary outcomes, like the blood loss, are compared.

Study Overview

• Status: Completed
• Conditions: Unstable Intertrochanteric Fracture
• Intervention / Treatment: Procedure: lateral decubitus postion during proximal femoral nailing for unstable intertrochnateric femur fractures; Procedure: Proximal femoral nailing for unstable intertrochnateric femur fractures in supine psoition using traction table

Detailed Description

To compare the fluoroscopic exposure time, quality of radiographic reduction, intra operative blood loss, setup time and surgical time between the lateral decubitus position and the use of a traction table in supine position in fixation of unstable intertrochanteric femur fractures by proximal femoral nail.

• Study Type: Interventional
• Enrollment (Actual): 77
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Cairo, Egypt, 11566
    • Ain shams university hospitals

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Skeletally mature patients
• Unstable intertrochanteric fracture ( AO/OTA type 31A2 & 31A3 )

Exclusion Criteria:

• Patients unfit for surgery
• Revision cases
• Patients with multiple or pathological, neglected or open fractures.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Lateral postion during proximal femoral nailing for unstable intertrochnateric femur fractures; Proximal femoral nailing in lateral decubitus position	Procedure: lateral decubitus postion during proximal femoral nailing for unstable intertrochnateric femur fractures; different positions of the patient during the surgery
Active Comparator: Supine postion using traction table in proximal femoral nailing intertrochanteric femur fractures; Proximal femoral nailing in supine position using traction table	Procedure: Proximal femoral nailing for unstable intertrochnateric femur fractures in supine psoition using traction table; different positions for the proximal femoral nailing

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of radiographic reduction	Optimum Tip-to-apex distance (TAD) is 25mm or less.; Normal femoral neck shaft angle between 125 and 145 degree.; The Baumgartner reduction quality criteria : -Criterion one (alignment) :Anterior posterior view : normal or slight valgus neck shaft anglelateral view : less than 20 degree of angulation (Slight valgus means a valgus of no more 10 degrees)Criterion two (displacement) :Anterior posterior view: less than 4 mm of displacement of any fragment.Lateral view: less than 4 mm of displacement of any fragment.The reduction will be categorized as good if both criteria were met, acceptable if only one criterion was met, and poor if Neither criterion was met.	immediate postoperative
Fluoroscopic exposure time	The fluoroscopic exposure time is defined as: The total duration of fluoroscopy use in minutes during the set up and the surgical procedure.	intraoperative

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Setup time	The period between the moment of transfer of the patient from the anesthesia team to the surgical team till the time of incision. This period includes placement of the patient on the surgical table or the traction table, preparation, and draping. The reduction and use of fluoroscopy during the reduction will be included within this time frame.	Intraoperative
Surgical time	The time between the skin incision and the closure of the wound.	Intraoperative

Collaborators and Investigators

• Sponsor: Ain Shams University
• Investigators: Study Director: Amr Ahmed Abd Elrahman Hasan, Professor of Orthopedics, Department of Orthoepdics - Faculty of Medicine - Ain Shams University

Study record dates

Study Major Dates

• Study Start (Actual): June 30, 2024
• Primary Completion (Actual): July 30, 2025
• Study Completion (Actual): July 30, 2025

Study Registration Dates

• First Submitted: February 8, 2026
• First Submitted That Met QC Criteria: February 8, 2026
• First Posted (Actual): February 13, 2026

Study Record Updates

• Last Update Posted (Actual): February 13, 2026
• Last Update Submitted That Met QC Criteria: February 8, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Proximal femoral nail; lateral decubitus; Unstable intertrochanteric fracture; proximal femoral fractures; traction table
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Hip Fractures; Femoral Neck Fractures; Proximal Femoral Fractures
• Other Study ID Numbers: FMASU MS734/2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Not decided yet

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No