Overcoming Anterior Breaches in the Distal Femur During Long Gamma Nailing.

Abstract

Anterior cortical penetration of distal femora when using long gamma nails is well established. To avoid this complication, using the appropriate entry point, a nail with a smaller radius of curvature, and intraoperative imaging is suggested. Despite this, there are times when the guidewire or the nail can abut or even perforate the anterior cortex. This is more likely to occur in patients with scalloped anterior distal femora and increased femoral anterior bowing. The authors overcome this potential problem during surgery by using a bent-tip guidewire. Their technique is cost neutral, safe, and quick. [Orthopedics. 2019; 42(1):e135-e137.].