Journal of Musculoskeletal Trauma

Original Articles

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; J Korean Fract Soc 2014;27(4):287-293. Published online October 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.4.287

Abstract PDF: 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.

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Results of Intramedullary Nailing of Femoral Shaft Fracture: Trochanteric Entry Portal (Sirus Nail) versus Piriformis Entry Portal (M/DN Nail): Sang Ho Ha, Woong Hee Kim, Gwang Chul Lee; J Korean Fract Soc 2014;27(1):50-57. Published online January 31, 2014; DOI: https://doi.org/10.12671/jkfs.2014.27.1.50

PURPOSE
To compare treatment results obtained using the trochanteric (Sirus nail) entry portal with those obtained using the Piriformis fossa (M/DN) entry portal during intramedullary (IM) nailing of femur shaft fractures.
MATERIALS AND METHODS
Four hundreds and thirty-two patients treated for femur shaft fracture using IM nails from February, 2001 to May, 2010 were divided into two groups. group 1 was composed of 180 patients treated through the trochanteric (Sirus nail; n=180) entry portal, while group 2 contained 170 patients treated through the piriformis fossa (M/DN nail; n=170) entry portal. We compared the clinical and radiographic findings of both groups to evaluate the treatment results.
RESULTS
Functional result, range of motion and union time (18, 20 weeks) were similar in both groups. The operation time of patients in the over-weighted group was 90 minutes in group 1 and 120 minutes in group 2 (p<0.05). Additionally, the blood loss was 280 ml in group 1 and 335 ml in group 2, and in case of over-weight patients, group 2 showed more blood loss (p<0.05). The duration of exposure to fluoroscopy differed slightly, with group 1 being less exposed than group 2; however, this difference was not significant (p>0.05). There were 18 iatrogenic fractures in group 1 and 4 in group 2 (p<0.05).
CONCLUSION
There was not much difference in complications based on clinical and radiographic findings of both groups. For groups using the trochanteric entry portal, the operation time was shorter and blood loss was lower than in groups using the piriformis entry portal. Iatrogenic fracture occurred more often in the group using the trochanteric entry portal than in the group using the piriformis entry portal.

Citations

Citations to this article as recorded by

Analysis of different entry portals for femoral nail with two different nail designs-straight nail versus lateral angulated nail - Does it make a difference?
Sanjay Yadav, Saurabh Singh, Anil Kumar Rai
Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 912. CrossRef
Comparing Entry Points for Antegrade Nailing of Femoral Shaft Fractures
Ujash Sheth, Chetan Gohal, Jaskarndip Chahal, Aaron Nauth, Tim Dwyer
Orthopedics.2016;[Epub] CrossRef
The Curative Effect Comparison Between Prolonged Third Generation of Gamma Nail and Prolonged Dynamic Hip Screw Internal Fixation in Treating Femoral Intertrochanteric Fracture and the Effect on Infection
Wenye He, Wei Zhang
Cell Biochemistry and Biophysics.2015; 71(2): 695. CrossRef
Treatment of Femur Subtrochanteric Fracture Using the Intramedullary Long Nail; Comparison of Closed Reduction and Minimal Open Reduction
Sang Joon Lee, Sang Hong Lee, Sang Soo Park, Hyung Seok Park
Journal of the Korean Orthopaedic Association.2015; 50(1): 18. CrossRef
Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
Journal of the Korean Fracture Society.2015; 28(1): 71. CrossRef
Treatment of the Femoral Fracture Using Sirus® Nail: A Comparison of Complication according to the Entry Potal
Young-Yool Chung, Dong-Hyuk Choi, Dae-Hyun Yoon, Jung-Ho Lee, Ji-Hun Park
Journal of the Korean Fracture Society.2015; 28(2): 103. CrossRef
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
Journal of the Korean Fracture Society.2014; 27(4): 287. CrossRef

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The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal: Hyun Kook Youn, Oog Jin Shon, Dong Sung Han; J Korean Fract Soc 2008;21(3):200-206. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.200

Abstract PDF: PURPOSE
To compare the results of IM nailing of femur shaft fractures using trochanteric and piriformis fossa entry portal.
MATERIALS AND METHODS
37 patients were treated with IM nail using Trochanteric (Trochanter group: TG, n=17) and piriformis fossa entry portal (piriformis group: PG, n=20) and were followed from February 2004 to 2007. The outcomes were assessed based on the clinical and radiographic findings.
RESULTS
The functional result, ROM and union time were similar in both groups. The alignment was similar in both groups but PG showed variable alignment in proximal 1/3. Incision was larger in PG (PG=8.7 cm, TG=5.8 cm, p<0.05) and there was a difference between overweight and normal weight group. Operative time was 95 minutes in PG, 87 minutes in TG (p>0.05), there was statistically significant difference in overweight groups (PG=125 minutes, TG=90 minutes, p<0.05). Blood loss was 313 cc in PG, 268 cc in TG and less in TG in overweight patients (p<0.05). There was 5.7degrees of varus angulation in PG, 2 nonunion cases in both groups.
CONCLUSION
The femoral nail specially designed for trochanteric insertion resulted in high union rates, low complication rates similar to conventional nail and the trochanteric nail can be the alternative choice especially in proximal femur fracture and overweight patients.

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