Trochanteric tip versus pyriformis entry for nails in femoral shaft fractures: Which is better?

Background: Entry point, either piriformis fossa entry (PFE) or greater trochanter entry (GTE) are the two recognized for IMN, but still debatable, which is better. The aim of this study was to determine which of the two-entry points (PFE or GTE) is preferable to the other for IMN of femoral shaft fractures. Method: A retrospective comparative study of patients with closed femoral shaft fractures (AO type 32-A or B) fixed by antegrade IMN, either GTE or PFE was included. Collected data includes demographic characteristics of both groups, mechanism of injury, AO Classification, Winquist classification, time to surgery, and associated injuries. Operative details, complications and postoperative outcomes were recorded. Functional evaluation using Harris Hip Score (HHS) and RUST score was done at the final follow-up visits. Results: 56 patients were operated for femoral shaft fractures (26 GTE -IMN, and 30 PFE-IMN), with male predominance. The fractures were classified according to AO Classification by either type A (35 patients) or type B (21 patients). Patients were operated on after a meantime 2.76± 2.46 days.