Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Antegrade intramedullary nailing is an accepted method of treatment for femoral shaft fractures. Entrance of the nail through the trochanteric fossa is currently recommended by some surgeons. This approach results in some cases, however, in loss of abduction strength and persistent pain. ⋯ Abductor muscles and tendons, branches of the medial circumflex femoral artery and the hip joint capsule were at risk during nail insertion through the trochanteric fossa. These structures were not endangered during insertion through the trochanteric tip. The reported clinical morbidity after nailing through the trochanteric fossa may result from direct soft tissue injury and may be reduced by choosing the route through the greater trochanter.