Intracortical screw insertion plus limited open reduction in treating type 31A3 irreducible intertrochanteric fractures in the elderly

Figure 1 Typical presentation of a female patient, who was 78-years-old. A: A radiograph of type 31A3 intertrochanteric fracture upon preoperative anteroposterior X-ray; B: A radiograph from intraoperative C-arm, which confirmed the irreducible intertrochanteric fracture; C-D: the insertion of proximal femoral nail antirotation without the need for Kirschner wires and other reduction instruments after limited open reduction with intracortical screws; E-F: The anatomical reduction of fracture upon anteroposterior and lateral X-rays.

Figure 2 Typical presentation of a male patient, who was 74-years-old. A: A preoperative 3D computed tomography reconstruction of type 31A3 intertrochanteric fracture; B: A radiograph from intraoperative C-arm, which confirmed the irreducible intertrochanteric fracture; C-E: The insertion of META-TAN without the need for Kirschner wires and other reduction instruments after limited open reduction with intracortical screws; F: The anatomical reduction of fracture upon postoperative anteroposterior X-ray.