The proximal part of the IM pin, protruding from the gluteal region, is connected with a connecting bar to a type one external fixator frame applied on the lateral side of the bone. Preferably, the ESF pins are placed in the proximal and distal parts of the femur to avoid interference with the muscular bellies. The most distal pin is inserted at the level of the trochlear region. The most proximal pin is inserted at the base of the greater trochanter directed towards the lesser trochanter, because this is the
thickest portion of the proximal femur.
The use of positive profile threaded pins is recommended.