Acta Orthopaedica et Traumatologica Turcica
Research Article

Estimating the optimal entry point of the antegrade femoral nailing: Previous and novel morphometric measurements

1.

Department of Anatomy, Hacettepe University, School of Medicine, Ankara, Turkey

2.

Clinic of Radiology, Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey

3.

Clinic of Orthopaedic and Traumatology, Memorial Hospital, Ankara, Turkey

4.

Department of Preventive Oncology, Hacettepe University, School of Medicine, Ankara, Turkey

AOTT 2022; 56: 81-87
DOI: 10.5152/j.aott.2022.21107
Read: 280 Downloads: 117 Published: 01 March 2022

Objective: This anatomical study aimed to investigate the possible relationships between the proximal femur parameters and verify the optimal entry point in line with the medullary canal.

Methods: Both in single image series and 3D-MPR views, 63 femur bones were evaluated. One-millimeter multidetector computed tomography scans were collected and assessed by OsiriX-Lite version 8 and Horos v3.3.5. Entry point locations, projected and true femoral neck-shaft, anteversion, and newly defined nail entrance angles were measured.

Results: The entry points of 16 femurs were placed at the tip of the greater trochanter, and the remaining 47 femurs were in the trochanteric fossa (i.e., piriformis fossa). Thirty-three of the entry points found in the trochanteric fossa were overlapped by the greater trochanter. When the parameters of the right and left sides were compared, it was found that; projected neck angle, nail entrance angle, and the differences between true neck angle and nail entrance angle were found significantly different. The relationship between nail entrance angle and entry point localization was assessed, and the probability of the entry point being at the tip of the greater trochanter is 63 times greater when the NEA is below 90.

Conclusion: This study has demonstrated that the ideal entry point for straight nails, which is based on the anatomic axis of the femur, is found mainly at the trochanteric fossa, and the greater trochanter overlapped 70.21% of them.

Level of Evidence: Level IV, Diagnostic Study

Cite this article as: Erçakmak Güneş B, Ilgaz HB, Çiledağ N, Özsoy H, Hayran M, Demiryürek D. Estimating the optimal entry point of the antegrade femoral nailing: Previous and novel morphometric measurements. Acta Orthop Traumatol Turc. 2022;56(2):81-87.

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ISSN 1017-995X EISSN 2589-1294