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European Journal of Orthopaedic Surgery & Traumatology

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01-12-2020 | Original Article

Does low body mass index constitute a risk of damage to the soft tissues during reaming for proximal femoral nailing? a cadaveric study

Authors: Mehmet Mesut Sonmez, Deniz Gulabi, Sinan Kahraman, Berna Senel, Cemil Erturk

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 8/2020

Abstract

Background

The purpose of this cadaveric study was to evaluate the damage to the gluteus medius muscle, tendon and superior gluteal nerve in low BMI patients during the reaming of the greater trochanter tip for proximal femoral nailing.

Materials and methods

The study used 19 femurs of 10 fresh femur intact cadavers [mean BMI: 22.79 (17.60–28.70)]. A guidewire was placed in the tip of greater trochanter under C-arm fluoroscopy, and a 17-mm reamer was advanced over the wire. After the reaming was completed, the hips were dissected and the gluteus medius muscle, tendon and superior gluteal nerve were inspected to evaluate the amount of injury.

Results

BMI was < 18.50 in 3 cadavers. The gluteus medius muscle was injured in all hips. The superior gluteal nerve was intact in all hips, but the thickness of gluteus medius muscle mass that remained intact was thicker in the cadavers with a higher BMI (3.86 mm for low BMI, 9.08 mm for high BMI group). The percentage of the tendon insertion disrupted by the reamer was an average of 36.20% in the low BMI group and an average of 26.93% in the high BMI group. The percentage of the tendon insertion disrupted by the reamer showed a statistically significant difference between low and high BMI cadavers.

Conclusion

The injury to the gluteus medius muscle and tendon after proximal femoral nailing through the greater trochanter tip may be higher in patients with low BMI. It must be kept in mind that gluteal muscle could be damaged during proximal femoral nailing and this could result in limping.

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Title: Does low body mass index constitute a risk of damage to the soft tissues during reaming for proximal femoral nailing? a cadaveric study
Authors: Mehmet Mesut Sonmez
Deniz Gulabi
Sinan Kahraman
Berna Senel
Cemil Erturk
Publication date: 01-12-2020
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 8/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02707-1

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Springer Medicine

Does low body mass index constitute a risk of damage to the soft tissues during reaming for proximal femoral nailing? a cadaveric study

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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