Anterior cortical overlap view in evaluation of anterior femoral cortical perforation and impingement during cephalomedullary nailing

Abstract

Cephalomedullary nailing of the femur is a common procedure associated with many pitfalls, including anterior femoral cortical perforation and impingement. Lateral knee radiographs are often inadequate in determining the precise location of the anterior cortex because of the offset of the medial and lateral femoral condyles. Here we present a novel radiographic technique to identify the distal anterior femoral cortex more accurately with the goal of reducing intraoperative and postoperative perforation during long cephalomedullary nailing.