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Re: PFN
Alexander Chelnokov 15 Апрель 2004, 23:29
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GT> the pyriformis fossa risks damage to the blood supply
GT> of the femoral neck and head. Personally, I am not
GT> convinced that this is the real reason for the change
AFAIK this is mostly related to children/adolescents?
GT> trochanter as an entry point for the ease of getting
GT> it right, ease of doing a small incision procedure.
How does it depend on the point of insertion?
GT> Cannulated nails also give one the comfort of using a
GT> guide wire, and many nails with cannulation can be
Either way allows to use the guide wire and cannulated nails, doesn't it?
GT> Also perhaps a lateralisation curve, that is from medial to
GT> lateral.
This is what i asked initially - i see that the curve intended for insertion through the trochanter, and try to realize why change the point from the piriformis to the troch...
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Re: PFN
George Thomas 18 Апрель 2004, 22:47
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AC> AFAIK this is mostly related to children/adolescents?
According to recent AO literature this is true also for adults.
GT>> it right, ease of doing a small incision procedure.
AC> How does it depend on the point of insertion?
Some surgeons (me included) feel it is easier because the trochanter is so easy to palpate, also the insertion device is away from the bulk of the gluteus (very large sometimes in fat people!).
GT>> Cannulated nails also give one the comfort of using a
GT>> guide wire, and many nails with cannulation can be
AC> Either way allows to use the guide wire and cannulated nails, doesn't
it?
This sentence was in relation to the AO unreamed nail which is solid, not cannulated.
GT>> Also perhaps a lateralisation curve, that is from medial to
GT>> lateral.
AC> This is what i asked initially - i see that the curve intended for insertion through the trochanter, and try to realize why change the point from the piriformis to the troch...
I thought I gave the AO's reasons for this at first. The rest of the mail was some random thoughts on nail design.
Warmest regards (40 degrees centigrade in Chennai!)
Dr. George Thomas,
Chennai, India
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