Authors: Sumit Kumar, Ritabh Kumar, Pushkar Chawla
Background: There is an increasing trend of use of cephalomedullary nail for the management of both stable and unstable intertrochanteric and subtrochanteric femoral fractures. Various western and Indian proximal femoral nails with different morphologies are available in Indian market that sometimes creates confusion amongst orthopedic surgeons about which nail to be preferred in different clinical scenarios for accurate outcomes. Material and Methods: Ten different types of long femoral nails with 10 mm diameter (5 Western and 5 Indian) available in Indian market were taken and the morphology of these were studied and compared for 9 parameters. Results: A lot of variation was seen amongst the Indian nails and western nails in proximal diameter, shape of proximal part of nail, distance of lag screw from tip, distance at which actual size of nail becomes 10mm, M-L angle (medio lateral angle), shape of nail shaft, configuration of distal screws, morphology of neck screw and centrum-collum –diaphyseal (CCD) angle. Conclusion: Design of a nail may prove to be superior in some type of patients and fractures but may not be suitable for others. Pre-operative templating is must and surgeons need to consider all the factors in unison while deciding the type of nail to be used. Keywords: Intertrochantric fractures, Proximal femoral nail.
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