De. Omalley et al., FEMORAL-HEAD AVASCULAR NECROSIS ASSOCIATED WITH INTRAMEDULLARY NAILING IN AN ADOLESCENT, Journal of pediatric orthopedics, 15(1), 1995, pp. 21-23
An adolescent developed avascular necrosis of the femoral head after i
ntramedullary nailing for a femoral diaphyseal fracture. This complica
tion is most likely secondary to injury to the posterior superior asce
nding branch of the medial circumflex artery at the time of rod insert
ion. This artery is situated close to the proximal insertion hole just
posterior to the trochanteric notch and piriformis fossa. Other metho
ds of fracture treatment, either operative or nonoperative, should be
considered in skeletally immature patients.