Abstract
Intertrochanteric fractures in the elderly present complex challenges due to poor bone quality and comorbidities. Cephalomedullary (CM) nails offer biomechanical advantages that support early mobilization, yet complications such as cutout, implant failure, and malalignment persist. This review examines the effectiveness of CM nail fixation in geriatric extracapsular hip fractures and introduces the RESCUE technique-a structured, mnemonic-based approach aimed at improving surgical outcomes and reducing common complications. RESCUE stands for Reduce, Entry point, Screw, Compress, Unleash traction, and Enhance full-weight bearing. This six-step framework addresses the critical elements of fixation, including precise reduction, optimal entry point selection, central screw placement, controlled fracture compression, cautious traction management, and early mobilization. Case illustrations of frequent failure patterns underscore the practical application of the RESCUE technique. By following this systematic approach, surgeons can enhance construct stability, minimize failure risk, and promote functional recovery in elderly patients.