Entry Point Related Outcome in Antegrade Femoral Nailing

152 Pages·2016·18.34 MB·English

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Entry Point Related Outcome
C
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C.M.S. Ansari Moein

Entry Point Related Outcome in
Antegrade Femoral Nailing
experimental and clinical studies
C.M.S. Ansari Moein
ENTRY POINT RELATED OUTCOME IN
ANTEGRADE FEMORAL NAILING
Experimental and clinical studies
C.M.S. Ansari Moein
The Robert Mathys Foundation, Bettlach, Switzerland and the AO Foundation, Davos,
Switzerland financially supported the studies presented in this thesis.
Kind contribution for the publication of this thesis by:
Erasmus Medical Centre Dept. of Surgery
Trauma Research Unit Erasmus MC (TRUE)
Parnassia Academy
ABN AMRO Bank
PsyQ
Maatschap Plastische Chirurgie Midden Brabant
THP Financial Guidance
Post Notariaat
Cover illustration by Rob Veen
Printing and lay-out by Optima Grafische Communicatie, Rotterdam, The Netherlands
ISBN 978-94-6169-867-4
© 2016. Copyright by CMS Ansari Moein
Entry Point Related Outcome in
Antegrade Femoral Nailing
experimental and clinical studies
Entreeplaats gerelateerde uitkomst van
antegrade mergpen ostheosynthese
bij femurfracturen
experimentele en klinische studies
Proefschrift
ter verkrijging van de graad van doctor
aan de Erasmus Universiteit Rotterdam
op gezag van de rector magnificus
Prof. Dr. H.A.P. Pols
en volgens besluit van het College voor Promoties
De openbare verdediging zal plaatsvinden op
vrijdag 20 mei 2016 om 13.30 uur
door
Chloé Mahsima Ansari Moein
geboren te Tehran, Iran
PROMOTIECOMMISSIE
promotoren:
Prof. dr. M.H.J. Verhofstad
Prof. dr. H.J. Ten Duis
overige leden:
Prof. dr. H.J. Stam
Prof. dr. J.A.N. Verhaar
Prof. dr. L.P.H. Leenen
All human beings are members of one frame,
Since all, at first, from the same essence came.
When time afflicts a limb with pain
The other limbs at rest cannot remain.
Sa’adi Shirazi. Bani Adam, Gulistan (The Rose Garden) 1258 A.D. Persia
To Matzi and Joun

CONTENTS
INTRODUCTION 8
Chapter 1 Historical perspective and study objectives 11
Chapter 2 Trochanteric fossa or piriform fossa of the femur: Time for 25
standardised terminology?
ANATOMICAL MODELS 36
Chapter 3 Soft tissue anatomy around the hip and its implications for 39
choice of entry point in antegrade femoral nailing
Chapter 4 Soft tissue injury related to choice of entry point in antegrade 53
femoral nailing: piriform fossa or greater trochanter tip
MECHANICAL MODEL 64
Chapter 5 Lateral insertion points in antegrade femoral nailing and their 67
influence on femoral bone strains
CLINICAL MODELS 84
Chapter 6 Functional outcome after antegrade femoral nailing: a 87
comparison between trochanteric fossa versus tip of greater
trochanter entry point
Chapter 7 Intramedullary nailing through the trochanteric fossa versus 105
greater trochanter tip: prospective randomized study with
in-depth functional outcome results
GENERAL DISCUSSION 120
Chapter 8 Discussion and concluding remarks 123
Chapter 9.1 English summary 135
Chapter 9.2 Dutch summary (Nederlandse samenvatting) 141
APPENDIX 146
Acknowledgments 149
INTRODUCTION