A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture

Abstract

<p class="abstract"><strong>Background:</strong> In case of close nailing for femoral shaft fractures, the nail is inserted into the medullary cavity through the proximal femur without disturbing the periosteal blood supply of at the fracture site. The piriformis fossa and greater trochanter has been commonly described as starting points for antegrade femoral nailing. The purpose of this study was to compare results of two entry ports being used for intramedullary nailing for femoral shaft fractures.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> This study was conducted during a period of one year. The patients admitted with femoral diaphyseal fractures for antegrade nailing were divided in two groups alternatively for piriformis fossa entry point and greater trochanter entry point. Total number of patient in each group was 25 (n = 25). Functional outcome were analyzed at final follow up using Hari’s hip score.</span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> There was no significant difference clinical and functional output in both group but intraoperative time and fluoroscopic time was significant (P <0.001).</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> Femoral nailing through the greater trochanter entry portal with specifically designed nails should be considered a rational alternative to femoral nailing compared to Piriformis fossa entry portal with the benefit of reduced requirement for fluoroscopy and decreased operative time in obese patients. Statistically no significant difference (>0.005) in clinical and Functional outcome based on Hari’s hip score.</span></p>

The outcome of antegrade intramedullary nail fixation of traumatic diaphyseal fractures of the femur in a tertiary care trauma center in Sri Lanka

“…However, given the limited resources, it is nearly impossible to offer early fixation for isolated femur shaft fractures in our setting. The median operating time of our study (195 minutes) was also comparatively longer than the reported durations for antegrade nailing (71 to 116 minutes) [2,[23][24][25] probably due to poor resources such as the limited availability of the C arm for surgeries. However, the rate of surgical site infections (3 out of 46) was comparable to the previous studies [23,24].…”

Incidence of Varus Malalignment Post Interlocking Nail in Proximal Femur Shaft Fractures Comparing Two Types of Entry Points

“…Osteosynthesis of the femur using an intramedullary nail is considered to be the gold standard for treating diaphyseal fractures of the femur. This is considered to be superior to extramedullary fixation using plates and external fixators, from both the biomechanical and the clinical points of view 2 . Intramedullary nail provides predictable restoration of shaft length and alignment and allowed early load bearing.…”