Technique for percutaneous insertion of intramedullary nail for intertrochanteric hip fracture.
Department of Orthopedics, Kingsbrook Jewish Medical Center, Brooklyn, New York 11203, USA.American journal of orthopedics (Belle Mead, N.J.) 04/2004; 33(3):117-20; discussion 120.
Intramedullary nailing has been proven to have biomechanical advantages over the use of a side plate and screw system. Further advantages may be gained with the use of a percutaneous technique, thereby minimizing blood loss, operative time, and overall morbidity. This article describes a technique for inserting an intramedullary nail percutaneously using a minimal-incision technique by utilizing fluoroscopy in cases of intertrochanteric hip fracture.
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ABSTRACT: Intramedullary nailing of the femur is often the treatment of choice in isolated fractures of the femoral shaft. Some surgeons are reticent to use intramedullary nailing for proximal and distal femoral fractures. However, indications for femoral nailing can be appropriately extended to highly comminuted fractures as well as distal and proximal fractures when the correct technique and reduction maneuvers are utilized. Implementation of these techniques will also respect the critical soft tissue envelope that is so important in fracture healing. Deforming forces of the muscles of the hip, knee and thigh are neutralized with reduction tools applied percutaneously, blocking screws and Schanz pins. Mastery of these techniques and appropriate reduction are incumbent on the orthopaedic surgeon treating femoral shaft fractures.
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