PROXIMAL FEMUR [Case 4] · Double See-saw Technique

Unstable, multifragmentary transtrochanteric fractures in osteoporotic bone represent a major reduction challenge in orthopedic trauma. This training demonstrates, in an objective manner, the application of the double seesaw technique for percutaneous reduction and control of the femoral calcar and femoral shaft, associated with fixation using an intramedullary nail, without the use of a traction table; in 4K video from the surgeon’s perspective. TRAINING FOCUS Percutaneous reduction using the seesaw technique (lever mechanics utilizing muscle mass) Comfortable reduction of the inferiorly displaced femoral shaft Correction of femoral calcar displacement (positive) Two simultaneous seesaw maneuvers Precise guide wire positioning (AP and lateral) Osteosynthesis with intramedullary nail in unstable fracture Technique without the use of a traction table DETAILED CONTENT Controlled Percutaneous Reduction: Practical application of levers with clamps and instruments for direct manipulation of fragments Mastery of the Seesaw Technique: Use of muscle mass as a fulcrum for multiplanar fracture correction Correction of Inferior Displacement of the Shaft: Mechanical strategy to restore alignment in the lateral view Fine Adjustment of the Femoral Calcar: Reduction of valgus deformity through direct manipulation with percutaneous instruments Stable Maintenance of Reduction: Team coordination for continuous stabilization during the procedure Optimized Guide Wire Positioning: Centralization in the femoral neck and head, avoiding an oblique sliding screw Execution without a Traction Table: Increased intraoperative mobility for dynamic reduction adjustments Intramedullary Nail Technical Sequence: Entry point, reaming, positioning, and locking with precision Prevention of Technical Errors: Real-time intraoperative corrections based on fluoroscopy INCLUDED MATERIAL Detailed PDF: Structured summary of the seesaw technique applied to the proximal femur, including biomechanical principles, instrument positioning, reduction strategies for the shaft and femoral calcar, intramedullary nail sequence, and critical points to avoid malalignment and implant failure. Master percutaneous reduction in complex proximal femur fractures without the use of a traction table and expand your intraoperative control. Access the training and elevate your surgical precision.