Intramedullary femoral nailing through the trochanteric fossa versus greater trochanter tip: a randomized controlled study with in-depth functional outcome results

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
C M S Ansari MoeinChr van der Werken

Abstract

In a level 1 university trauma center, an explorative randomized controlled study was performed to compare soft tissue damage and functional outcome after antegrade femoral nailing through a trochanteric fossa (also known as piriform fossa) entry point to a greater trochanter entry point in patients with a femoral shaft fracture. Nineteen patients were enrolled and randomly assigned to two nail insertion groups; ten patients were treated with an Unreamed Femoral Nail(®) (UFN, Synthes(®), Solothurn, Switzerland) inserted at the trochanteric fossa and nine patients were treated with an Antegrade Femoral Nail(®) (AFN, Synthes(®), Solothurn, Switzerland) inserted at the tip of the greater trochanter. The main outcome measures were pain, gait, nerve and muscle function, along with endurance. Magnetic resonance imaging (MRI), electromyography (EMG), and Cybex isokinetic testings were performed at, respectively, 2 and 6 weeks and at a minimum of 12 months after surgery. The MRI and EMG showed, in both groups, signs of iatrogenic abductor musculature lesions (four in the UFN group and four in the AFN group) and superior gluteal nerve injury (five in the UFN group and four in the AFN group). The isokinetic measurements and the patient-r...Continue Reading

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Citations

Dec 17, 2014·Evidence-based Child Health : a Cochrane Review Journal·Vrisha MadhuriPrathap Tharyan
Jul 30, 2014·The Cochrane Database of Systematic Reviews·Vrisha MadhuriPrathap Tharyan
Jun 21, 2017·Journal of Hip Preservation Surgery·Guy WaisbrodMartin Beck

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