Abstract

CLINICAL SIGNIFICANCE OF TROCHANTER SHAFT ANGLE AS DETERMINANT OF ALIGNMENT OF FEMORAL CANAL AND TROCHANTER IN MANAGEMENT OF FRACTURE SHAFT OF FEMUR

Lakhwani O. P., *Chetiwal Rajesh and Mittal P. S.

Abstract

Introduction: Femoral nailing is the one of the common procedure used for the fixation of fracture shaft of femur. Since relation of the medullary canal is not constant and collinear with the any specific point over trochanter hence it is difficult to insert nail and various entry points including pirriformis fossa, tip of greater trochanter has been used but anatomical determinant are not clearly defined. Aims and Objectives: Study aimed at analyzing the relevant anatomy of proximal femur on dry femur bone and skigram to determine the anatomical alignment of throchanter with medullary canal as angle between and its significance. Materials and Methods: Adult dry cadaveric femora and skigram were taken to measure angle between the trochanter and shaft of femur for safe and anatomical femoral nail insertion confirmed by retrograde insertion of remur and radiaogram. Results: Most favourable and least strainful path for uniplaner intramedullary nail lies in the line of medullary canal can be correlated with angle between the Trochanter and Shaft which ranges between 5-17 degrees on dry cadaveric femora and 4-14 degrees on skigram. Discussion: since trochanter is not collinear with the medullary canal and variation in the proximal femoral anatomy, it is difficult to define the any specific point as universal entry point for femoral nailing. Relation and angle between trochanter and central medullary cavity line can guide for selection of appropriate and safe entry point for intramedullary femoral nail insertion.

Keywords: pirriformis, skigram, throchanter, uniplaner, remur and radiaogram.