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Relationship of Femoral Intramedullary Pins to the Sciatic Nerve and Gluteal Muscles after Retrograde and Normograde Insertion
Author(s) -
PALMER ROSS H.,
ARON DENNIS N.,
PURINTON PAUL T.
Publication year - 1988
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.1988.tb00279.x
Subject(s) - medicine , intramedullary rod , gluteal region , sciatic nerve , anatomy , femoral nerve , gluteal muscles , buttocks , surgery
An anatomic analysis of retrograde and normograde intramedullary (IM) pinning of proximal, midshaft, and distal femoral fractures was performed in 28 canine cadavers. For all fracture locations, normograde pins were significantly more cranial in the middle gluteal muscle than retrograde pins (p < 0.01). There was no significant difference between pinning techniques in craniocaudal position of the IM pin in the superficial gluteal muscle. In distal fractures, normograde pins were placed significantly more lateral than retrograde pins in the superficial gluteal muscle (p < 0.01). One of 15 normograde pins and 9 of 13 retrograde pins were located in the medial half of the trochanteric fossa. Normograde pins were significantly more lateral in the trochanteric fossa than were retrograde pins in midshaft fractures (p < 0.01). Normograde pins were significantly (p < 0.01) farther from the sciatic nerve than retrograde pins when the hip was positioned at coxofemoral flexion angles of 85° in midshaft and 110° in distal fractures. Seven of 13 retrograde pins, but none of 15 normograde pins, contacted the sciatic nerve. Normograde pinning of the femur may be less likely to induce sciatic nerve injury, particularly in midshaft and distal fractures.