Validation of alignment and rotation
Reduction is confirmed using local landmarks and/or intraoperative fluoroscopy. Reduction is adjusted as necessary prior to locking the nail. Rotational alignment can be judged by palpation or by direct visualization of the greater trochanter and femoral trochlea or by examination of the adductor magnus muscle. The distal part of the femur is held in a true lateral position. The position of the greater trochanter is then inspected.
If the femur is correctly aligned in the axial plane the greater trochanter should be slightly caudal to the long axis of the bone.