Should It Stay or Should It Go? The Postless Technique for Intertrochanteric Fracture Fixation Using a Traction Table: A Case Series Describing a Technical Approach to Avoid Perineal Post–Related Complications
Robinson E. Pires1,2,7*, Christiano Saliba Uliana3, André Wajnsztejn4, Gustavo Tadeu Sanchez5, Gustavo Waldolato1,6,7, Pablo Jose Carrasco Ordoñez1,7, Rafael Guillermo Gallego Andrade1,7, Mário Augusto Alves Andrade Filho1,7
1Orthopaedic Trauma Unit, Felicio Rocho Hospital. Belo Horizonte (MG), Brazil.
2Department of the Locomotor System. Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
3Pelvic reconstruction Unit, Hospital do Trabalhador, Curitiba (PR), Brazil.
4Orthopaedic Trauma Unit, Hospital Israelita Albert Einstein, São Paulo (SP), Brazil.
5Orthopaedic Trauma Unit, Universidade Federal de São Paulo, São Paulo (SP), Brazil.
6Orthopaedic Trauma Unit, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte (MG), Brazil.
7Orthopaedic Trauma Unit, Instituto Orizonti, Belo Horizonte (MG), Brazil.
*Corresponding Author: Robinson Esteves Pires, Department of the Locomotor System, School of Medicine, Federal University of Minas Gerais, Belo Horizonte (MG), Brazil. ORCID: 0000-0002-3572-5576
https://doi.org/10.58624/SVOAOR.2026.06.003
Received: January 03, 2026
Published: January 23, 2026
Citation: Pires RE, Uliana CS, Wajnsztejn A, Sanchez GT, Waldolato G, Carrasco Ordoñez PJ, Gallego Andrade RG, Andrade Filho MAA. Should It Stay or Should It Go? The Postless Technique for Intertrochanteric Fracture Fixation Using a Traction Table: A Case Series Describing a Technical Approach to Avoid Perineal Post–Related Complications. SVOA Orthopaedics 2026, 6:1, 20-27. doi: 10.58624/SVOAOR.2026.06.003
Abstract
Objectives: To describe a modified postless technique for cephalomedullary fixation of intertrochanteric femoral fractures, potential benefits and limitations, as well as their clinical and radiographic results.
Methods: This is a prospective cohort study involving five patients undergoing intertrochanteric fracture fixation with a postless technique. Clinical and radiographic outcomes were evaluated over a 6-month follow up period.
Results: All five cases (four 31-A2 and one 31-A1) achieved satisfactory intraoperative fracture reduction without the need to convert to a perineal post. Radiographic union was obtained within three months in all patients. No postoperative complications were observed.
Conclusion: The modified postless technique appears to be a feasible and safe alternative for intertrochanteric fracture fixation, offering the benefits of traction table use while avoiding perineal post related complications.
Keywords: Bone nails, Femoral fractures, Fracture fixation (intramedullary), Orthopedic procedures, Pudendal nerve, Traction