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Greater trochanteric vs piriformis fossa entry nailing for femur shaft fractures: An unresolved controversy

Injury Jul 19, 2019

Kumar P, et al. - Given that the preferred treatment for the shaft of femur fractures in adults is intramedullary nailing in which antegrade nails involve entry through either piriformis fossa (PE) or greater trochanteric (GT) tip, researchers conducted a systematic review investigating if one entry point is superior to the other by comparing their related outcome parameters like operative time, exposure to fluoroscopy, mal-unions, non unions, abductor weakness, varus malalignment and Harris Hip scores. Searching three databases of PubMed, EMBASE and SCOPUS, they identified a total of 9 studies published between the years 2011 to 2017 for analysis. Outcomes suggest that for treating shaft of femur fractures in adults, GT entry nails are superior to PE nails. For GT entry nails vs PE nails, the learning curve was shorter and functional outcomes were better, but rates of union were comparable.
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