Risk of Superior Gluteal Nerve and Gluteus Medius Muscle Injury During Femoral Nail Insertion

Özsoy, Metin; Başarır, Kerem; Bayramoǧlu, Alp; Erdemli, Bülent; Tüccar, Eray; Ekşioğlu, Mehmet Fatih

doi:10.2106/00004623-200704000-00019

Cited by 32 publications

(14 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Özsoy et al proved that there is a risk that the superior gluteal nerve is damaged due to the different flexion positions of the hip during the closed intramedullar fixation procedure [15].…”

Section: Discussionmentioning

confidence: 99%

The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

et al. 2013

View full text Add to dashboard Cite

The purpose of this study is that to evaluate superiority and results of open technique in the treatment of femoral shaft fracture with interlocking intramedullary nailing. The retrospective study is designed to evaluate results of our technique. In this study, the patients that were admitted to the Orthopedics and Traumatology Department of University Hospital that is third level of trauma center. We claim that open technique is not a disadvantage during union process over closed technique in treatment of femoral shaft fracture with interlocking nailing. In this study, 44 patients that were consulted for adult femoral shaft fracture between January 2008 to July 2010 were included. Patients with open fractures, gunshot wounds, neurovascular injuries, and patients that did not have isolated femoral diaphysis fractures were excluded from the study. Clinical and radiological results of the patients were checked periodically. The open interlocking intramedullary nailing was used in treatment. Complete union rate was 90.9 % in 40 patients who were treated with open interlocking intramedullary nailing for adult femoral shaft fracture, and nonunion rate was 9.1 % in four patients. Mean union time was 18.3 weeks (12-36-weeks

show abstract

Section: Discussionmentioning

confidence: 99%

The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The purpose of the current study was to determine the incidence of the damage to the SGN in patients treated with PFN and PFN-A. The anatomic course of the SGN has been documented in various anatomical and clinical studies [9][10][11][12][13][14][15]20,21]. Branches of the nerve are within the surgical field during the gluteal splitting approach to the piriformis fossa as well as the greater trochanter tip.…”

Section: Discussionmentioning

confidence: 99%

“…The EMGs were performed by the same neurophysiologist. The mean time between surgery and EMG examination was 18.2 [14][15][16][17][18][19][20][21] months. The muscles were evaluated by the criteria of the American Academy of Electrophysiological Medicine for needle EMG.…”

Section: Methodsmentioning

confidence: 99%

“…Although it has been asserted that the nails minimize soft tissue trauma due to percutaneous application, it is known that the entry points of these nails are not within the safe zone for the SGN. Anatomic studies have confirmed that the inferior branch of the SGN follows an oblique course anteriorly and caudally from piriformis fossa in the sagittal plane within the substance of gluteus medius muscle; therefore, injury to the nerve may be inevitable during percutaneous nail insertion [12][13][14][15]. In this study we retrospectively evaluated the patients who underwent proximal femoral nailing for trochanteric fractures, in order to investigate the presence of SGN injury and its clinical findings.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the Superior Gluteal Nerve During Proximal Femoral Nailing

S�nmez¹

2017

Ann Clin Anal Med

View full text Add to dashboard Cite

ÖzetAmaç: Kalça cerrahisi sırasında süperior gluteal sinir etkilenebilir. Bu çalışma-da stabil olmayan trokanterik kırıklar nedeni ile proksimal femoral çivileme uygulanan hastalar, süperior gluteal sinir hasarı mevcutdiyetini ve bunun klinik bulgularını değerlendirmek amacıyla retrospektif olarak değerlendirilmiş-tir. Gereç ve Yöntem: Bu çalışmaya 25 hasta dahil edilmiştir (14 kadın, 11 erkek). Çalışmaya Hastanemiz Ortopedi Bölümü'ne başvuran proksimal femoral çivileme uygunana hastalar dahil edilmiştir. Kırık fiksasyonu için aynı dizayna sahip iki ayrı çivi ve aynı cerrahi teknik uygulanmıştır. Serebrovasküler hastalık hikayesi olan, polinöropatinin elektromyografik bulguları olan veya dejeneratif vertabral hastalığı bulunanan hastalar çalışmadan çıkartılmıştır. Hastalar klinik ve radyolojik olarak değerlendirilmiştir. Gluteus maksimus kasında akut denervasyon ile ilişkili bulgular ve motor ünite aksyon potansiyelindeki değişiklikler superior gluteal sinir hasarı bulguları olarak kabul edilmişir. Bulgular: Sekiz hasta yürüme sırasında destek kullanmıştır, bu hastaların üçün-de pozitif Trendelenburg belirtisi mevcttur ancak yalnızca bir hastada süpe-rior gluteal sinirde akut denervasyon bulguları saptanmıştır. Tartışma: Bu ça-lışmaya göre iyatrojenik sinir hasarı insidansı proksimal femoral çivilemenin nadir görülen bir komplikasyonudur. Yaşlı hastalarda sinir hasarından bağım-sız olarak, aksama ve destek kullanma ihtiyacı meydana gelebilir. Anahtar KelimelerHasar; Elektromyografi; Proksimal Femoral Çivileme; Süperior Gluteal Sinir Abstract Aim: The superior gluteal nerve may be compromised during hip surgery. We retrospectively evaluated the patients who underwent proximal femoral nailing for unstable trochanteric fractures in order to investigate the presence of superior gluteal nerve injury and its clinical findings. Material and Method: Twenty five patients (14 women, 11 men) were included in the study who had femoral nailing between January 2004 and March 2010 at Hamidiye Sisli Etfal Training and Research Hospital Department of Orthopaedics. Two different types of nails which have similar designs and surgical techniques were used for fracture fixation. Patients who had a history of cerebrovascular disease, electromyography findings of polyneuropathy, or degenerative vertebral disease were excluded from the study. Patients were evaluated clinically and radiologically. Findings related to acute denervation in the gluteus medius muscle and motor unit action potential changes were accepted as signs of superior gluteal nerve injury. Results: Eight patients were using support during walking and three of these patients had positive Trendelenburg sign, but only one patient had acute denervation signs of the superior gluteal nerve. Discussion: Based on the present study the incidence of iatrogenic nerve injury is a rare complication of proximal femoral nailing. Elderly patients, regardless of whether they have nerve injury, may limp and need to use a walking support.

show abstract

“…[7,9,11] Extramedullary implants are useful to minimize problems such as superior gluteal nerve injury, associated abductor weakness, and heterotopic ossification, which may likely to complicate intramedullary nailing. [2,12,13] Although successful results were reported with the use of the traditional 95º-angled blade plate (ABP), [4,11,12] the development of secondary varus collapse, cut out, and failure in these plates were observed. [4,11,12,14] Recently, the proximal femoral locking plates (PFLPs) which have a fixed-angle stable construct and high pull-out strength have been developed to minimize possible complications in such fractures.…”

mentioning

confidence: 99%

A comparison of proximal femoral locking plate versus 95-degree angled blade plate in the treatment of reverse intertrochanteric fractures

Azboy

Demirtaş

Gem

et al. 2014

Eklem Hastalik Cerrahisi

View full text Add to dashboard Cite

The mean time to union was 17 weeks (range 14-28) and 18 weeks (range 16-32) in the PFLP group and ABP group, respectively. Implant failure and/or nonunion was observed in two patients (10%) in the PFLP group and in three patients (12%) in the ABP group. There was no statistically significant difference between the groups with regard to the Harris hip scores, time to union, need for reoperation due to mechanical problems, and complication rates (p>0.05). Conclusion: Our study results show that these two fixation methods seem to produce similar results in the treatment of reverse intertrochanteric fractures with greater trochanteric comminution. However, we suggest that ABP still remains as a good choice with less expense in such fractures.

show abstract

Risk of Superior Gluteal Nerve and Gluteus Medius Muscle Injury During Femoral Nail Insertion

Cited by 32 publications

References 17 publications

The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

Evaluation of the Superior Gluteal Nerve During Proximal Femoral Nailing

A comparison of proximal femoral locking plate versus 95-degree angled blade plate in the treatment of reverse intertrochanteric fractures

Contact Info

Product

Resources

About