Intramedullary Nailing of Subtrochanteric Fractures

Abstract

Summary: Antegrade femoral nailing of subtrochanteric femoral fractures often is more complex than intramedullary nailing of more distal femoral shaft fractures. Proper preoperative planning, patient positioning, and proper attainment of the entry portal will allow for a more precise and easier operation. In this article, 3 entry portals—the piriformis fossa, the typical lateral trochanteric, and the modified medial trochanteric—which are commonly used for antegrade femoral nailing are described and discussed. Additionally, patient positioning, in both the supine and lateral position, is discussed in this article.