Augmentation plating leaving the nail in situ is an excellent option for treating femoral shaft nonunion after IM nailing: a multicentre study

Author(s):  
Christiano Saliba Uliana ◽  
Fernando Bidolegui ◽  
Kodi Kojima ◽  
Vincenzo Giordano
1998 ◽  
Vol 8 (3) ◽  
pp. 129-137 ◽  
Author(s):  
J.P. Holland ◽  
F.A. Weber

Complete removal of femoral shaft cement during revision hip surgery is a difficult task prone to complications. If the cement bone interface is intact however, is there a place for its preservation and re-use with a new cemented stem? The results are reported of 51 cement within cement femoral stem revisions carried out between 1984 and 1991 with a minimum of 5 years’ follow-up, and a mean of 7.8 years. Excluding patients lost or deceased, 39 hips in 38 patients were reviewed clinically and radiologically. Eighty-two percent of these were still functioning in situ, 72% were excellent or good using the HSS scoring system and 97% had no radiological evidence of loosening. Femoral stem failure due to aseptic loosening occurred in 4 cases (10%) between 4 and 12 years after revision. Comparing this series to a previous revision hip series by the senior author, there appears to be no deterioration in long term results using this technique, and a better long term radiological outcome.


Injury ◽  
1998 ◽  
Vol 29 (5) ◽  
pp. 393-394 ◽  
Author(s):  
P. Nicholson ◽  
J. Rice ◽  
J. Curtin

2017 ◽  
pp. 19-29
Author(s):  
Nasir Hussain ◽  
Farrah Naz Hussain ◽  
Corey Sermer ◽  
Hera Kamdar ◽  
Emil H. Schemitsch ◽  
...  

Background: There are several different techniques commonly used to perform intramedullary (IM) nailing of the femur to fix femoral fractures. We sought to identify significant differences in outcomes of studies comparing 1) trochanteric and piriformis entry and 2) antegrade and retrograde entry in IM nailing of the femur. Methods: We searched MEDLINE, Cochrane and Embase databases and the Orthopaedic Trauma Association and American Academy of Orthopaedic Surgeons websites for comparative studies published from inception to November 2015. Criteria used to select articles for detailed review included use of antegrade and retrograde entry point or use of trochanteric and piriformis entry point for IM nailing of the femur in adult patients. Functional and technical outcomes were extracted from accepted studies. Results: We identified 483 potential studies, of which 52 were eligible. Of these, we included 13 publications and 2 abstracts (2 level I, 7 level II and 6 level III studies). Trochanteric entry significantly reduced operative duration by 14 min compared with piriformis entry (p = 0.030). Retrograde nailing had a greater risk of postoperative knee pain than antegrade nailing (p = 0.05). On the other hand, antegrade nailing had significantly more postoperative hip pain (p = 0.003) and heterotopic ossification (p < 0.001) than retrograde nailing. No significant differences in functional outcomes were observed. Conclusion: Although some significant differences were found, the varying quality of studies made recommendation difficult. Our meta-analysis did not confirm superiority of either antegrade over retrograde or trochanteric over piriformis entry for IM nailing of the femur. Level of evidence: Level III therapeutic.


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