Aseptic Necrosis of the Femoral Head Following Antegrade Nailing of Femoral Fractures in Adolescents

Summary Although aseptic necrosis of the femoral head is infrequent after intramedullary nailing of femoral shaft fractures in adolescents, it is a significant complication. Changes in technique and in nail size and design should reduce the risk of iatrogenic aseptic necrosis. Insertion of the nail through the tip of the greater trochanter is recommended in skeletally immature patients because it better avoids injury to the lateral ascending circumflex artery than does insertion through the piriformis fossa.