Fractures shaft femur have been treated with antegrade nailing via the piriform fossa(PF). The purpose of this study was to compare results of fracture shaft femur treatment with nailing through the greater trochanter(GT) to nailing through PF with specifically designed nails. 80 patients were included in the study. (GT group;n=37 and PFgroup;n=43) between May 2011- September 2014. Functional outcome was evaluated by Thoresen scoring. Operative time, number of fluroscopy shots required to make the entry point, time to fracture union and complications were compared and evaluated using appropriate statistical methods. 86% patients(37) showed excellent results and 14%(6) good results in PF group and 88%(33) excellent results and 12%(4) good results in GT group(statistically insignificant). The mean operative time of PF=90 mins and GT=75 mins(P<0.005). The average number of image intensifier shots to create the entry point in PF=11 and GT=8(P<0.005). A femoral nail specifically designed for trochanteric insertion is an alternate technique with benefit of decreased radiation exposure and operative time, more so in obese patients.
