The American journal of orthopedics
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Antegrade intramedullary nailing using the piriformis fossa as an entry point for insertion has become the treatment of choice for most diaphyseal fractures of the femur. In obese or well-muscled patients, however, creating an entry point can be difficult. ⋯ Unfortunately, retrograde nailing is associated with higher nonunion rates and increased incidence of knee pain and stiffness. We describe an antegrade nailing technique that is useful and easy to perform even in obese patients.