Where is the insertion point for the trochanteric approach of an antegrade femoral nail?
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The correct location for the trochanteric entry point is just next to the tip of the greater trochanter in the AP view. It is important that the entry be exactly centered on the axial view, in order to prevent eccentric reaming.
How do you nail a femur?
The surgeon will make an incision near the hip joint in order to insert a rigid rod (intramedullary nail) through the femur. The rod is fixed by screws at both ends and will keep the bone stable in order to ensure proper healing. In most cases, neither a cast nor brace will be required post-surgery.
What is femoral nail insertion?
An intramedullary nail is a metal rod that is inserted into the medullary cavity of a bone and across the fracture in order to provide a solid support for the fractured bone. Intramedullary nailing is currently considered the “gold standard” for treatment of femoral shaft fractures (Rudloff 2009).
What is retrograde nailing femur?
Purpose of the study: Retrograde nailing represents an established fixation method for fractures of the distal femur and offers in femoral shaft fractures an alternative to the existing technique of antegrade nailing.
What is trochanter shaft angle of femur?
Results. Trochanter-Shaft angle ranges between 5–17 degrees in anthropometric study and 4–14 degrees in radiological study. Proximal femoral Anthropometry and Trochanter-shaft angle is variable; hence it is difficult to fix any anatomical point as a universal entry point for antegrade femoral nail insertion.
Where is the trochanteric fossa located?
The deep depression posteriorly between the trochanter and head is the trochanteric fossa. On the posterior surface of the shaft, just distal to the head, is the lesser trochanter. The intertrochanteric line connects the two trochanters, but is especially defined along the posterior edge of the greater trochanter.
What is proximal femoral nailing?
The proximal femoral nail (PFN) is an osteosynthetic implant designed to treat proximal femoral fractures in the trochanter area with a closed intramedullary fixation method.
What are the key benefits to intramedullary nailing in the distal femur?
In any fracture fixation, the advantages of intramedullary nailing include indirect reduction with less stripping of periosteal blood supply and preservation of soft tissues and the fracture hematoma with its bone-forming cells and factors.
How do you remove a femoral nail?
The cone-shaped femoral extractor on the extraction bar is inserted into the wound, over the guide pin. The extractor is gently but forcefully screwed into the nail. The first pass may not fully engage the nail, but it will remove much of the interposed soft tissue.
What is an intramedullary reamer?
Reaming mobilises cancellous bone inside the medullary canal. Exchange reamed nailing is a standard procedure in patients with nonunion after fractures. There appears to be stimulation of revascularisation by the breaking-up of intramedullary scar tissue.
What is a retrograde nail?
Retrograde femoral nailing can be defined as any femoral nailing technique with a distal entry from the condyles or through an intercondylar, intra-articular starting point.
What is the proper entry point at the distal femur?
The proper entry point at the distal femur should be 1.5 +/- 2.01 mm medial and 12 +/- 2.72 mm superior to the top of the femoral intercondylar notch. Conclusion: The result of this study could be useful for surgeons who prefer intramedullary guide system in total knee arthroplasty.
What is the best position for femoral nailing?
Most femoral nailing procedures are performed with antegrade nailing position. It is extremely successful and utilizes minimally invasive techniques. The piriformis entry point is used for straight nails.
How do you find the entry point of a nail?
The soft-tissue track for determination of the entry point should deviate less than 15° from the axis of the femoral shaft to avoid any stress on the femoral neck upon insertion of the nail. X-ray showing the correct position of the guide wire.
What type of nailing is used for femoral nail surgery?
General considerations Most femoral nailing procedures are performed with antegrade nailing position. It is extremely successful and utilizes minimally invasive techniques. The trochanteric entry point is used for proximally curved nails.