Why the study?
Does a minimally invasive nail insertion technique reduce the incidence of malalignment in patients with subtrochanteric femur fractures?
Does a minimally invasive nail insertion technique reduce the incidence of malalignment in patients with subtrochanteric femur fractures?
The minimally invasive nail insertion technique may help decrease the incidence of malalignment in subtrochanteric femur fractures by addressing common technical errors.
May warrant technique consideration to limit malalignment; leaves open need for prospective validation before practice change.
Summary: Although the healing rates have been quite acceptable, higher rates of malalignment have been consistently reported for intramedullary nailing of subtrochanteric femur fractures when compared with diaphyseal fractures. Three common technical errors occur when dealing with these difficult fractures: (1) imprecise portal location, (2) poor control of the trajectory and reamer pathway in the proximal metaphysis, and (3) lack of preservation of the proximal femur during subsequent fracture reduction and reaming maneuvers. The concepts of precision entry, trajectory control, and portal preservation, which are integral to the minimally invasive nail insertion technique, can be useful tools in the effort to decrease the incidence of malalignment of subtrochanteric femur fractures.
No takes yet. Share an insight, caveat, or question.
Mir et al. (2008) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: