The patient is operated upon in the supine position with a bump under the affected hip on a radiolucent table. The old incisions were re-opened, and the previous hardware was removed, temporarily stabilizing the femoral neck fracture with K wires.
The proximal femur was prepared for the blade plate using the seating chisel, in the correct angle as determined by the pre-operative plan, under careful fluoroscopic control. The osteotomy cuts are approximated by placing Kirschner wires to guide the saw blade. The level of the distal cut is at the top of the lesser trochanter. The cuts are started with a saw. Additional K wires are placed to keep rotation of the femur accurate, accounting for any correction required.
The blade plate is partially inserted, the osteotomy cuts are completed and the wedge removed. The blade plate is fully seated, the leg is brought out into abduction to meet the plate, and a clamp is applied. Rotation is verified, blade position is checked in AP and lateral planes, and the plate is applied under tension using the articulated tensioning device and eccentrically placed screws. The removed wedge of bone is ground up and used for bone graft.
A large fragment LC-DCP is placed to stabilize the partially healed femoral shaft fracture. Radiographs are obtained in the operating room Figure 6 and Figure 7.