Percutaneous manipulation of an osteoarthritic hip for femoral nailing.

: An increasing number of elderly patients with femoral shaft fractures also have coexisting osteoarthritis of the hip. This proves to be difficult both in fracture reduction [1] and localisation of the point of entry into the piriform fossa. To facilitate guide wire entry in a patient with osteoarthritis of the hip, considerable adduction of the hip may be required during conventional closed antegrade femoral nailing. We describe a technique using a Steinman pin on a T-clamp to facilitate localisation of the piriform fossa.