Professor-Abdelsalam EidThe lesser trochanter is a part of the distal fragment which is good. If the greater trochanter could be provisionally fixed to the distal fragment this would be like a two part intertrochanteric fracture, or a basal neck. In which case a DHS would work. In addtion, the side plate would stabilize the G troch fragment. Otherwise, a gamma nail could be used.
Fahad AbduljabbarPut a uni cortical one third tubular plate to hold the GT to the shaft , then do ur reduction under fluoroscopy .. Then fire wires in the superior and inferior neck .. After that pass your cephalomedullary nail wire just medial to the tip of GT following that , use a bone hook around the inferomedial neck to maintain your reduction while reaming and drilling for the locking helical blade or screw .. Once u pass the nail in and the helical blade is in .. You can remove the anti rotational wires from the neck and do your distal locking ..
Note that u can use a short nail .. No need for a long one
Mohamed KamalAll options mentioned above can be applied.but i guess we will face aproblem in making entry with DHS so, i prefer proximal femoral locked plate with antiroratory screw as i seems to be basicervical rather than intertrochanteric fr.
Sam KershI think DHS is very bad option, DCS may be a good solution because of the reverse obliquity or cemented Bipolar Prosthesis with stabilisation of the greater trochanter via K-wires and cercalge.