Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture

Jong-Hee Lee; Jong-Hoon Park; Si-Yeong Park; Seong-Cheol Park; Seung-Beom Han

doi:10.12671/jkfs.2014.27.4.287

Journal List > J Korean Fract Soc > v.27(4) > 1037998

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Lee, Park, Park, Park, and Han: Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture

Original Article

Journal of the Korean Fracture Society 2014; 27(4): 287-293.

Published online: 20 October 2014

DOI: https://doi.org/10.12671/jkfs.2014.27.4.287

Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture

Jong-Hee Lee, M.D., Jong-Hoon Park, M.D., Si-Yeong Park, M.D., Seong-Cheol Park, M.D., Seung-Beom Han, M.D.

Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Korea.

Address reprint requests to: Seung-Beom Han, M.D. Department of Orthopedic Surgery, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. Tel: 82-2-920-5924, Fax: 82-2-924-2471, oshan@korea.ac.kr

Received 19 May 2014 Revised 21 July 2014 Accepted 31 July 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to compare the clinical outcome of femoral shaft fracture treatment with intramedullary nailing performed using a greater trochanter and a piriformis entry nail.

Materials and Methods

A total of 57 patients treated by antegrade nailing for a femoral shaft fracture between January 2008 and April 2013 were included in this study. We evaluated postoperative radiographs of 57 femoral shaft fractures stabilized with femoral intramedullary nailing at a single institutional center. The cases included 25 piriformis fossa entry nails and 32 greater trochanter entry nails. Outcome measures included the alignment, union rate and duration of union, complications, operation time, intra-operative bleeding, and a pain rating scale.

Results

The alignment, union rate, and duration of union did not differ significantly between the groups with piriformis fossa and trochanteric nailing. In addition, no significant differences regarding complications and operation time were observed between the two groups. Less intra-operative bleeding was observed in the trochanteric nailing group. This difference was statistically significant (p=0.044).

Conclusion

Use of a femoral nail specially designed for the trochanteric insertion resulted in equally high union rates, duration of union, and low complication rates. Thus, greater trochanter entry nails were similar to conventional antegrade femoral nailing through the piriformis fossa.

Keywords: Femur, Shaft fracture, Intramedullary nailing, Greater trochanter, Piriformis fossa

Figures and Tables

Fig. 1

Applications of expert asian femoral nail. (A) Preoperative radiographs of a 51-year-old woman with a closed femoral shaft fracture after a motorcycle accident. (B) Postoperative radiographs at six months showing nearly complete union.

Fig. 2

(A) Preoperative radiographs of a 21-year-old woman with a closed femoral shaft fracture after a fall from a five-meter-high rooftop. (B) Radiographs at 16 months showing a united fracture with 6° of valgus deformity.

Table 1

Patient Characteristics

Values are presented as number or mean±standard deviation.

Table 2

Outcome Assessment

Values are presented as number (%), number only, or mean±standard deviation.

Notes

Financial support: None.

Conflict of interest: None.

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