Sagittal Plane Considerations During Long Cephalomedullary Nailing: Optimal Distal Positioning and the Role of Intraoperative Nail Bending

Objective: To retrospectively review a large population of long cephalomedullary nails with special attention to distal implant position in the sagittal plane and assess the ability to avoid anterior cortical contact (ACC) by bending the distal tip of the nail intraoperatively. Design: Retrospective review of single surgeon experience. Setting: Single Level 1 trauma center. Outcomes: Radiographic position of the cephalomedullary nail with respect to the anterior femoral cortex and the effects of intraoperative bending of the distal tip of the nail. Patients: A total of 215 patients who underwent long cephalomedullary nailing for peritrochanteric hip fractures between 2007 and 2017 were reviewed. Results: In the period between 2007 and October 2013, ACC of the distal portion of the nail in the sagittal plane was a common finding. Its incidence significantly decreased after intraoperative bending of long cephalomedullary nails was incorporated into practice in cases where sagittal plane impingement was detected (P
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research