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[Femoral nailing using a helical nail shape (LFN(®))].
1Sektion für Traumatologie, Berufsgenossenschaftliche Unfallklinik Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Deutschland, jrether@bgu-tuebingen.de.
Operative Orthopadie Und Traumatologie
|August 15, 2014
Summary
Antegrade femoral nailing using helical nails offers a safe entry point, particularly for obese patients. However, this technique did not show significant advantages over conventional methods in a 12-month study.
Area of Science:
- Orthopedic surgery
- Traumatology
- Biomedical engineering
Background:
- Antegrade femoral nailing via a greater trochanteric entry portal is a surgical technique for femur fractures.
- This approach aims to minimize damage to surrounding soft tissues and neurovascular structures.
- A helical nail design is required to accommodate the necessary bending for this insertion pathway.
Purpose of the Study:
- To evaluate the efficacy and outcomes of antegrade femoral nailing using helical nails.
- To assess the safety and ease of use of this technique in treating femoral shaft and neck fractures.
Main Methods:
- A prospective multicenter study involving 227 patients treated with helical nails for antegrade femoral nailing.
- Indications included femoral shaft fractures (type 32-A/B/C) and femoral neck fractures (type 31-B).
- Surgical technique involved a dorsolateral approach to the greater trochanter, with specific guide wire placement and nail insertion to achieve 90° external rotation.
Main Results:
- Follow-up at 12 months was available for 74% of patients.
- Surgeons reported excellent or good ease of entry site identification in 89% of cases.
- No significant benefits in functional or radiological outcomes were observed compared to conventional antegrade femoral nails at 12 months.
Conclusions:
- Antegrade femoral nailing with helical nails provides a technically feasible and safe approach, particularly beneficial for obese patients.
- While the entry portal technique is well-tolerated, the helical nail design does not confer superior clinical or radiological outcomes compared to standard antegrade nails within the study period.
