Risk of Superior Gluteal Nerve Injury After Using Ante-Grade Femoral Nailing
Mehdi Moghtadaei1, Babak Otoukesh1, Peyman Kaghazian2, Negin Hatami3 , Bahram Boddouhi1 and Ali Yeganeh1*1Department of Orthopedic Surgery, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran 2Department of Orthopedic Surgery , Universitätsklinikum Bonn , Bonn , Germany 3MD, Zanjan University of Medical Science , Zanjan , Iran. Corresponding author Email: yeganeh471@yahoo.com
Abstract: Antegrade intramedullary femoral nailing (AIFN) is used as the preferred treatment for diaphyseal and subtrochanteric femur fractures. Nevertheless, clinically important complications associated with obtaining nail entry including loss of hip abductor strength, chronic hip pain, heterotopic ossification and femoral head osteonecrosis have been previously shown.This study was aimed to evaluate the risk of injury to the superior gluteal nerve when Ante-grade femoral nailing is used for insertion. In current study, 25 patients with femoral shaft fractures were included in this study that 21 were male with an average age of 25.40 years, Also 4 cases were female with an average age of 28.20 years. The patients were between the ages of 93 to 05 years. EMG-MCV was taken from all patients and were reported by neurologist. Plain radiographs were taken from all patients. Pain intensity of patients in the last month were identified from 4 to 944 according to the patients statements. The frequency of patients with subjective lameness separately with or no signs was determined. In terms of the pain score, its average among all patients was calculated to be 4.92, while the average of 4.75 among men was calculated. Among women, the average was 5.60. All patients had a mean duration of 3.64 months for using crutches, that the average duration of 3.80 months for men and 3 months for women were calculated.In terms of subjective limping, 15 patients (60%) complained from limping, while 10 people were not affected (40 %), of which, 12 patients (80%) was belonged to men group and 3 patients (20%) were assigned in women group. 5 patients were diagnosed with atrophy of gluteus medius and gluteus minimus muscles that, 3 patients were male (60%) and 2 cases (40%) were women respectively. EMG-NCV indicated that the Superior gluteal nerve injury had occurred in 2 patients (8%) and myogenic damage of gluteus medius and gluteus minimus muscles in 5 patients (20%). Our study indicated that the superior gluteal nerve injury had occurred in 2 8% of patients and myogenic damage of gluteus medius and gluteus minimus muscles in 20%.
Keywords: Ante-grade femoral nailing; Gluteus; Lameness; Patient; Injury Back to TOC