Reduction and fixation of the trochanteric flip
The trochanteric fragment is held with a sharp bone clamp or, in smaller patients, with a towel clip. The assistant brings the extended straight leg into 20-30° of abduction. This relaxes the gluteal muscles and facilitates reduction of the trochanter. The trochanteric fragment is temporarily fixed with a 2.0 mm smooth K-wire, which is inserted by hammering the wire into the femur.
The greater trochanteric fragment can be fixed with two 3.5 mm cortex screws. It is recommended that these screws are inserted perpendicular to the osteotomy plane and reach the contralateral cortex of the femur. The distal screw should be tightened first. The K-wire is removed after insertion of the second screw.