Prevention of cortical breach during placement of an antegrade intramedullary femoral nail.

The radius of curvature of femoral intramedullary nails does not match the average radius of curvature of the human femur. Anterior cortical breach of the distal femur during nail placement has been reported in certain fracture patterns, in femora with a smaller radius of curvature, and at the starting point of the nail. The authors describe a novel technique used to prevent anterior cortical disruption of the femur using multiple percutaneously placed Steinmann pins. This technique ensures safe passage of medullary reamers and the femoral nail.