Abstract
First, correct the shortening with a traction table. A ballspike reduction tool is introduced under radiographic guidance through a percutaneous anterolateral incision, lateral and inferior to the anterior superior iliacspine (to avoid the lateral cutaneous nerve of the thigh). This is then used to depress the proximal part of the fracture while a crutch placed under the leg at the distal fracture site provides a countering force (Fig 2). This allows the guidewire to be passed across the fracture site and enables the procedure to be completed without need for formal open reduction. Care must be taken not to leave the crutch in place for an extended period of time as this risks compressing the sciatic nerve.
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