AO Surgery Reference

Reduction top

Anatomical reduction of varus and retroversion. enlarge

Anatomical reduction of varus and retroversion.

Overcorrection of the femoral head in slight valgus and anteversion – as advised in B3 fractures – is not possible in 31-B2 fractures.
Reduction can usually be obtained with traction and internal rotation of the fractured leg.
If this is not successful, unfasten the patient and try a Leadbetter reduction maneuver.


Leadbetter maneuver enlarge

Leadbetter maneuver.

Flex the hip to 90° with slight adduction and apply traction in line with the femur axis. Next rotate internally. The leg is then slowly circumducted into abduction.
Extend the leg while maintaining traction?Overcorrection of the femoral head in slight valgus and anteversion – as advised in B3 fractures – is not possible in 31-B2 fractures.
Reduction can usually be obtained with traction and internal rotation of the fractured leg.
If this is not successful, unfasten the patient and try a Leadbetter reduction maneuver.


If retroversion persists, push the thigh by hand in a ventral to dorsal direction. enlarge

Persistent retroversion

If retroversion persists, push the thigh by hand in a ventral to dorsal direction.
Check reduction under image intensification or with x-rays in two planes.
If closed reduction is still unsuccessful, open reduction should be performed.