Blunt Hohman-Lever Technique for Reduction of Intertrochanteric Fracture – A Surgical Technique

Main Article Content

Raviraj A.
K. Abhishek Sugumar
Vidyasagar Maalepati
Vivek Kumar N. Savsani
Ashish Anand


We present a 60 years old patient who presented to us with history of domestic fall and sustained injury to the right hip and was diagnosed with trochanteric fracture right side. As closed reduction was not acceptable and bone spike was not available in the set, we designed our own technique of using a bone lever introduced from the same incision from where reaming/nail insertion was done. To the best of our knowledge this technique has never been described before in english literature. Since our first case we have tried it in 6 other patients and without any issues.

Blunt bone-lever technique, trochanteric fracture, surgical technique, injury.

Article Details

How to Cite
A., R., Sugumar, K. A., Maalepati, V., Savsani, V. K. N., & Anand, A. (2020). Blunt Hohman-Lever Technique for Reduction of Intertrochanteric Fracture – A Surgical Technique. Journal of Advances in Medicine and Medical Research, 32(17), 1-7.
Short Communication


Sambandam SN, Chandrasekharan J, Mounasamy V, Mauffrey C. Intertrochanteric fractures: A review of fixation methods. Eur J Orthop Surg Traumatol. 2016;26(4):339–353. Available: 0-016-1757-z

Bellabarba C, Herscovici D Jr, Ricci WM. Percutaneous treatment of peri trochanteric fractures using the Gamma nail. Clin Orthop Relat Res. 2000;375:30–42.

Curtis MJ, Jinnah RH, Wilson V, Cunningham BW. Proximal femoral fractures: A biomechanical study to compare intramedullary and extramedullary fixation. Injury. 1994; 25(2):99–104.

Saudan M, Lubbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P. Per trochanteric fractures: Is there an advantage to an intramedullary nail?: A randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma. 2002;6(6):386–393.

Simmermacher RK, Bosch AM, Van der Werken C. The AO/ASIF-proximal femoral nail (PFN): A new device for the treatment of unstable proximal femoral fractures. Injury. 1999;30(5):327–332.

Utrilla AL, Reig JS, Munoz FM, Tufanisco CB. Trochanteric gamma nail and compression hip screw for trochanteric fractures: A randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail. J Orthop Trauma. 2005;19(4):229–233.

Schipper IB, Marti RK, van der Werken C. Unstable trochanteric femoral fractures: Extramedullary or intramedullary fixation. Review of literature. Injury. 2004;35(2): 142–151.

Streubel PN, Moustoukas M, Obremskey WT. Locked plating versus cephalo-medullary nailing of unstable intertrochanteric femur fractures. Eur J Orthop Surg Traumatol. 2016;26(4):385–390. Available:https :// 0-016-1743-5

Kokkalis ZT, Mavrogenis AF, Ntourantonis DI, Igoumenou VG, Antoniadou T, Karamanis R, Megaloikonomos PD, Panagopoulos GN, Giannoulis D, Souliotis E, Saranteas T, Papagelopoulos PJ, Panagiotopoulos E. Reduction techniques for difficult subtrochanteric fractures. Eur J Orthop Surg Traumatol. 2019;29(1):197-204. DOI: 10.1007/s00590-018-2239-2. Epub 2018 May 31

Pape HC, Tarkin IS. Intraoperative reduction techniques for difficult femoral fractures. J Orthop Trauma. 2009;23(5): S6–S11. Available: e3181 9f275 4

Haidukewych GJ. Intertrochanteric fractures: Ten tips to improve results. J Bone Joint Surg Am. 2009;91(3):712–719.

Russel TA. Subtrochanteric femur fractures: Reconstruction nailing. In: Hurley R, LePlante M (eds) Master techniques in orthopedic surgery: fractures, 2nd edn. Lippincott Williams & Wilkins, Philadelphia. 2006;291–322.

Winquist RA. Locked femoral nailing. J Am Acad Orthop Surg. 1993;1(2):95–105.

Ostrum RF, Marcantonio A, Marburger R. A critical analysis of the eccentric starting point for trochanteric intramedullary femoral nailing. J Orthop Trauma. 2005; 19(10):681–686.

Farrar MJ, Binns MS. Percutaneous reduction for closed nailing of femoral shaft fractures. J R Coll Surg Edinb. 1996; 41(4):267–268.

Georgiadis GM, Burgar AM. Percutaneous skeletal joysticks for closed reduction of femoral shaft fractures during intramedullary nailing. J Orthop Trauma. 2001;15(8):570–571.

Moeller TB, Reif E. Lower extremity. In: Verlagsgruppe (ed) Pocket atlas of sectional anatomy: Computed tomography and magnetic resonance imaging. Thieme, Stuttgart, New York. 2007;116–140.

Angelini A, Battiato C. Past and present of the use of cerclage wires in orthopedics. Eur J Orthop Surg Traumatol. 2015;25(4): 623–635. Available: 0-014-1520-2

Angelini A, Battiato C. Combination of low-contact cerclage wiring and osteosynthesis in the treatment of femoral fractures. Eur J Orthop Surg Traumatol. 2016;26(4):397–406. Available: 0-016-1761-3

Afsari A, Liporace F, Lindvall E, Infante A Jr, Sagi HC, Haidukewych GJ. Clamp-assisted reduction of high subtrochanteric fractures of the femur: Surgical technique. J Bone Joint Surg Am. 2010;92(1,2):217–225. Available:

Kim Y, Dheep K, Lee J, Yoon YC, Shon WY, Oh CW, Oh JK. Hook leverage technique for reduction of intertrochanteric fracture. Injury. 2014; 45(6):1006-10. DOI: 10.1016/j.injury.2014.02.007. Epub 2014 Feb 15

Ruecker AH, Rueger JM. Pertrochanteric Fractures: Tips and Tricks in Nail Osteosynthesis. Eur J Trauma Emerg Surg. 2014;40(3):249-64. DOI: 10.1007/s00068-013-0366-3. Epub 2014 Jan 29.