A presentation created and delivered by me in the weekly meeting of our unit in the orthopedic surgery department in National Ribat Teaching Hospital (Khartoum, Sudan) on the 28th of August 2018. In it I present the content of a scientific paper from 2010. The paper is titled "“Intertrochanteric Fractures:Ten Tips to Improve Results”". It is composed of the following parts: - The author, journal and article - The 10 tips The paper can be found here: https://www.ncbi.nlm.nih.gov/pubmed/20415401

1. Abdalla Mutwakil Gamal
Medical Officer
Mr Mohammed Babiker Unit
Department of Orthopedic Surgery
National Ribat Teaching Hospital
Khartoum, Sudan

3.  An Instructional Course Lecture,
American Academy of Orthopaedic
Surgeons
 Trained at the Mayo Clinic
 Director of orthopedic trauma
 Academic chairman for the
Orthopedic Faculty Practice
 Professor at the University of Central
Florida College of Medicine
 Award-winning researcher
 100+ peer reviewed publications and
book chapters
 20+ patents and has developed
multiple innovative implants for
fracture fixation and joint
replacement.

4.  1948-present
 The journal is the official
publication of the:
• British Orthopaedic Association
• Canadian Orthopaedic
Association
• New Zealand Orthopaedic
Association
• Australian Orthopaedic
Association, and
• Sociedade Brasileira de
Orthopedia e raumatologia.
 Impact factor: 3.581 (2017)

8.  Tip 1: Use the Tip-to-Apex Distance
 Tip 2: ‘‘No Lateral Wall, No Hip Screw’’
 Tip 3: Know the Unstable Intertrochanteric
Fracture Patterns, and Nail Them
 Tip 4: Beware of the Anterior Bow of the
Femoral Shaft
 Tip 5: When Using a Trochanteric Entry Nail,
Start Slightly Medial to the Exact Tip of the
Greater Trochanter
 Tip 6: Do Not Ream an Unreduced Fracture

9.  Tip 7: Be Cautious About the Nail Insertion
Trajectory, and Do Not Use a Hammer to
Seat the Nail
 Tip 8: Avoid Varus Angulation of the Proximal
Fragment—Use the Relationship Between the
Tip of the Trochanter and the Center of the
Femoral Head
 Tip 9: When Nailing, Lock the Nail Distally if
the Fracture Is Axially or Rotationally
Unstable
 Tip 10: Avoid Fracture Distraction
When Nailing

10. Planning:
• Nail or Screw?
• Nail or screw properties
Execution:
• Open
• Reduce
• Fix
• Close

11. Planning:
• Nail or Screw? (Tip 2 & 3)
• Nail or screw properties? (Tip 4)
Execution:
• Open
• Reduce (Tip 6)
• Fix (Tip 5, 7 & 10 when nailing)(Tips 1 & 8 for
position)(Tip 9 for locking)
• Close

15. A REVERSE OBLIQUITY
FRACTURE.
A TRANSTROCHANTERIC
FRACTURE

16. A FOUR-PART FRACTURE WITH A
LARGE POSTEROMEDIAL FRAGMENT
A FRACTURE WITH
SUBTROCHANTERIC EXTENSION.

19. Nothing.

23.  Nailing:
 Tip 5, 7 & 10
 Position:
 Tips 1 & 8
 Locking:
 Tip 9

31.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix
• Close
 Tip 2: ‘‘No Lateral Wall,
No Hip Screw’’
 Tip 3: Know the Unstable
Intertrochanteric Fracture
Patterns, and Nail Them

32.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix
• Close
 Tip 4: Beware of the
Anterior Bow of the
Femoral Shaft

33.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix
• Close
 Nothing

34.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix
• Close
 Tip 6: Do Not Ream an
Unreduced Fracture

35.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix - Nailing
• Close
 Tip 5: When Using a
Trochanteric Entry Nail,
Start Slightly Medial to
the Exact Tip of the
Greater Trochanter
 Tip 7: Be Cautious
About the Nail Insertion
Trajectory, and Do Not
Use a Hammer to Seat
the Nail
 Tip 10: Avoid Fracture
Distraction
When Nailing

36.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix - position
• Close
 Tip 1: Use the Tip-to-Apex
Distance
 Tip 8: Avoid Varus
Angulation of the Proximal
Fragment—Use the
Relationship Between the
Tip of the Trochanter and
the Center of the Femoral
Head

37.  Planning:
• Nail or Screw?
• Nail or screw properties
 Execution:
• Open
• Reduce
• Fix - Locking
• Close
 Tip 9: When Nailing, Lock
the Nail Distally if the
Fracture Is Axially or
Rotationally Unstable