Derotational osteotomies utilizing a trochanteric-start intramedullary nail.

In the November 2014 Journal of Pediatric Orthopaedics B, Pailhé et al. [1] outlined a technique for the surgical treatment of adolescent femoral antetorsion with an intramedullary nail. They specified a trochanteric-start nail to avoid avascular necrosis of the femoral head that could occur from a piriformis entry point. We applaud the efforts of the authors to avoid the devastating consequences of avascular necrosis of the femoral head. However, we have concerns that their technique, as described, could lead to potentially fatal fat embolism.

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[3]  J. Sales de Gauzy,et al.  Response to 'Comment on the article 'Derotational femoral osteotomy technique with locking nail fixation for adolescent femoral antetorsion: surgical technique and preliminary study' by Pailhé et al.'. , 2015, Journal of pediatric orthopedics. Part B.

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