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Intramedullary Nailing of a Subtrochanteric Femur Fracture: Piriformis Entry in the Lateral Position

March 01, 2017

Contributors: Jacob Kirsch, MD; Todd Conlan, MD; Mark Hake, MD

Surgical management of subtrochanteric femur fractures in the multiply injured patient poses several challenges due to concomitant injuries and various patient factors. Treatment of these fractures with an intramedullary nail in the lateral decubitus position on a regular radiolucent table with manual traction may be advantageous, however can be technically challenging. Various factors such as optimal patient positioning, operating room set up, draping strategies, and understanding of regional anatomy are essential for successful management of these fractures. Furthermore, the technical aspects of obtaining an accurate starting point and fracture reduction are paramount. In this video, we describe a safe and reproducible technique for the surgical management of subtrochanteric femur fractures utilizing an intramedullary nail with a piriformis starting point in the lateral position. The advantages and indications for using this technique are discussed. Additionally, the typical patient presentation, imaging findings, operating room set-up, pertinent anatomy and fracture reduction strategies are reviewed in detail.

Results for "Hip and Pelvis"

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