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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma

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Treatment of the Femoral Fracture Using Sirus(R) Nail: A Comparison of Complication according to the Entry Potal
Young Yool Chung, Dong Hyuk Choi, Dae Hyun Yoon, Jung Ho Lee, Ji Hun Park
J Korean Fract Soc 2015;28(2):103-109.   Published online April 30, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.2.103
AbstractAbstract PDF
PURPOSE
The purpose of this study is to analyze the clinical results of fixation using Sirus(R) nail in patients with femoral subtrochanteric and shaft fracture and the difference in the frequency of complications according to the entry portal.
MATERIALS AND METHODS
From July 2006 to August 2013, at least 1-year clinical follow-up, we retrospectively analyzed 36 cases with femoral subtrochanteric (15 cases) and shaft fracture (21 cases) who underwent surgery using Sirus(R) nail. We reviewed the records of operation time, intra-operative amounts of bleeding and complications. At last follow-up, we reviewed clinical results by Ray-Sanders criteria and analyzed the periods of bone union on the radiograph. We also measured changing of the femoral neck-shaft angle in the subtrochanteric fractures and angulation in the shaft fractures, respectively. Considering anatomical variation of the trochanter and fracture position of subtrochanteric and femoral shaft, entry points were divided into subgroups, and the clinical results were compared.
RESULTS
The mean Ray-Sanders score was 27.4, 27 cases (75.0%) were good or excellent. The mean periods of bone union was 21.1 weeks in 31 cases. The mean neck-shaft angles were 135.7o preoperatively, 130.2o postoperatively. The mean angulation of the femur was 24.4o preoperatively, 2.4o postoperatively in patients of femoral shaft fractures. Despite no statistical significance, greater trochanter tip entry point and lateral entry point had a higher rate of frequency than medial entry point, with respect to the occurrence of iatrogenic fracture and malalignment.
CONCLUSION
Using Sirus(R) nail for femoral subtrochanteric and shaft fractures showed good clinical and radiographic results and a high rate of union. Medial entry point yielded slightly better results in the occurrence of iatrogenic fracture and malalignment, compared to greater trochanter tip entry point and lateral entry point.
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Results of Intramedullary Nailing of Femoral Shaft Fracture: Trochanteric Entry Portal (Sirus Nail) versus Piriformis Entry Portal (M/DN Nail)
Sang Ho Ha, Woong Hee Kim, Gwang Chul Lee
J Korean Fract Soc 2014;27(1):50-57.   Published online January 31, 2014
DOI: https://doi.org/10.12671/jkfs.2014.27.1.50
AbstractAbstract PDF
PURPOSE
To compare treatment results obtained using the trochanteric (Sirus nail) entry portal with those obtained using the Piriformis fossa (M/DN) entry portal during intramedullary (IM) nailing of femur shaft fractures.
MATERIALS AND METHODS
Four hundreds and thirty-two patients treated for femur shaft fracture using IM nails from February, 2001 to May, 2010 were divided into two groups. group 1 was composed of 180 patients treated through the trochanteric (Sirus nail; n=180) entry portal, while group 2 contained 170 patients treated through the piriformis fossa (M/DN nail; n=170) entry portal. We compared the clinical and radiographic findings of both groups to evaluate the treatment results.
RESULTS
Functional result, range of motion and union time (18, 20 weeks) were similar in both groups. The operation time of patients in the over-weighted group was 90 minutes in group 1 and 120 minutes in group 2 (p<0.05). Additionally, the blood loss was 280 ml in group 1 and 335 ml in group 2, and in case of over-weight patients, group 2 showed more blood loss (p<0.05). The duration of exposure to fluoroscopy differed slightly, with group 1 being less exposed than group 2; however, this difference was not significant (p>0.05). There were 18 iatrogenic fractures in group 1 and 4 in group 2 (p<0.05).
CONCLUSION
There was not much difference in complications based on clinical and radiographic findings of both groups. For groups using the trochanteric entry portal, the operation time was shorter and blood loss was lower than in groups using the piriformis entry portal. Iatrogenic fracture occurred more often in the group using the trochanteric entry portal than in the group using the piriformis entry portal.

Citations

Citations to this article as recorded by  
  • Analysis of different entry portals for femoral nail with two different nail designs-straight nail versus lateral angulated nail - Does it make a difference?
    Sanjay Yadav, Saurabh Singh, Anil Kumar Rai
    Journal of Clinical Orthopaedics and Trauma.2019; 10(5): 912.     CrossRef
  • Comparing Entry Points for Antegrade Nailing of Femoral Shaft Fractures
    Ujash Sheth, Chetan Gohal, Jaskarndip Chahal, Aaron Nauth, Tim Dwyer
    Orthopedics.2016;[Epub]     CrossRef
  • The Curative Effect Comparison Between Prolonged Third Generation of Gamma Nail and Prolonged Dynamic Hip Screw Internal Fixation in Treating Femoral Intertrochanteric Fracture and the Effect on Infection
    Wenye He, Wei Zhang
    Cell Biochemistry and Biophysics.2015; 71(2): 695.     CrossRef
  • Treatment of Femur Subtrochanteric Fracture Using the Intramedullary Long Nail; Comparison of Closed Reduction and Minimal Open Reduction
    Sang Joon Lee, Sang Hong Lee, Sang Soo Park, Hyung Seok Park
    Journal of the Korean Orthopaedic Association.2015; 50(1): 18.     CrossRef
  • Failure to Remove a Trochanteric Entry Femoral Nail and Its Cause in Adolescent Patients: Two Cases Report
    Ji-Hwan Kim, Seung-Oh Nam, Young-Soo Byun, Han-Sang Kim
    Journal of the Korean Fracture Society.2015; 28(1): 71.     CrossRef
  • Treatment of the Femoral Fracture Using Sirus® Nail: A Comparison of Complication according to the Entry Potal
    Young-Yool Chung, Dong-Hyuk Choi, Dae-Hyun Yoon, Jung-Ho Lee, Ji-Hun Park
    Journal of the Korean Fracture Society.2015; 28(2): 103.     CrossRef
  • Comparison of Greater Trochanter Versus Piriformis Entry Nail for Treatment of Femur Shaft Fracture
    Jong-Hee Lee, Jong-Hoon Park, Si-Yeong Park, Seong-Cheol Park, Seung-Beom Han
    Journal of the Korean Fracture Society.2014; 27(4): 287.     CrossRef
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