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Non-anatomic reduction
2%
64/3137
Mismatch of the radius of curvature of implant and bone
91%
2866/3137
Usage of too large an implant
59/3137
Lateral patient positioning
1%
20/3137
Lateral proximal starting point
4%
115/3137
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Anterior perforation of the femur has been attributed to a simple mismatch in the radius of curvature of implants and the apex anterior bowed femur. The radius of curvature is generally smaller (114-120 cm) than many earlier generation femoral nails (up to 300 cm), and the referenced article by Ostrum et al describes a case series of 3 such patients with subtrochanteric fractures. He noted that the difference in femoral anteroposterior bow between the bone and the implant is a contributing factor to distal femoral anterior cortex penetration in intramedullary nailing of subtrochanteric fractures. Illustration A shows an example of a nail penetrating the anterior femoral cortex.
3.8
(21)
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