Intramedullary nailing for open fractures of the femoral shaft: evaluation of contributing factors on deep infection and non-union using multivariate analysis [Injury 2005;36:1085–93]

Background: Femoral shaft fractures are an important cause of mortality and morbidity in the lower extremity injuries.Methods: 21 femoral body fractures of 19 adult patients were treated with the unreamed intramedullary nailing. Of 19 patients 14 were males and 5 were females.Results: All fractures healed. Deep infection was not encountered. According to the Thoresen criteria, the rate of excellent-good results was 78%. In two patients, who had also cranial trauma, development of excessive callus was observed. None of the patients required a secondary operation. Conclusions: Unreamed intramedullary nailing, if it can be implemented with closed technique and with double lock screw at the distal side, provides satisfactory results in the femoral shaft fractures.

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Determine the Mean Duration of Union in Femoral Shaft Fracture in Children Treated with Elastic Intra-Medullary Nailing

10.53350/pjmhs211551338 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1338-1340

Author(s):

M. S. Zardad ◽

M. Younas ◽

S. A. Shah ◽

I. Muhammad ◽

M. Ullah ◽

...

Keyword(s):

Intramedullary Nailing ◽

Functional Outcomes ◽

Femoral Shaft Fracture ◽

Femoral Shaft ◽

Shaft Fracture ◽

Femoral Shaft Fractures ◽

Non Union ◽

Shaft Fractures ◽

Fractures In Children ◽

Medullary Nailing

Objective: The aim of this study is to determine the functional outcomes and mean duration of union in femoral shaft fracture in children treated with elastic intra-medullary nailing. Study Design:Retrospective Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute Abbottabad and District Headquarter Teaching Hospital Gomal Medical College Dera Ismail Khan for duration from May 2020 to January 2021 (09 months). Methods: Total sixty eight patients with age ranges between 5-12 years were presented in this study. Patients detailed demographics age, sex and BMI were calculated after taking informed written consent. Complete patients were treated with elastic intramedullary nailing. Radiological assessment was done. Mean union time and complications associated to procedure were examined. Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 8 months postoperatively. Complete data was analyzed by SPSS 22.0 version. Results: Out of 68 patients, there were 48 (68.6%) males and 20 (31.4%) females. Most of the patients 41 (60.35) were aged between 8-12 years and the rest 27 (39.65%) were between 5-8 years.34 (50%) fractures were caused because of road accidents, falling from height were 20 (29.41%), due to sports were 10 (14.70%) and 4 (5.9%) were due to simple fall. 32 (47.06%) patients had left side fracture and 36 (52.94%) had right side fracture. Mean union time among patients was 4.14±2.72 months and there was no any case of non union. According to Flyn’s criteria, 50 (73.53%) cases had excellent results, 14 (20.6%) patients had good and fair results were among 4 (5.9%) cases. Complications were observed bone stiffness, delayed union and varus deformity among all cases. Conclusion: We concluded in this study thatElastic intramedullary nailing for femoral shaft fractures in children is safe and effective treatment modality. Union of bone achieved all the patients and majority of patients had excellent functional outcomes. Keywords: Femoral shaft fractures, Children, Elastic intra-medullary nail

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A clinical study on the surgical management of fracture shaft femur in children and adolescents by using Ender’s nail

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20163125 ◽

2016 ◽

Vol 2 (3) ◽

pp. 169

Author(s):

Raghu Kumar J. ◽

Sri Harsha Gutta

Keyword(s):

Intramedullary Nailing ◽

Age Groups ◽

Femoral Shaft ◽

Limb Length Discrepancy ◽

Limb Length ◽

Safe Procedure ◽

Rotational Malalignment ◽

Non Union ◽

Length Discrepancy ◽

Shaft Fractures

Background: Femoral shaft fractures account for 1.6% of all pediatric bony injuries. Current treatment options include early spica casting, traction, external fixation, open reduction and internal fixation with plating, flexible intramedullary nails and intramedullary rods. Experience of many clinicians has shown that children with diaphyseal fractures do not always recover with conservative treatment. Ender rod fixation in the paediatric population is simple, effective and minimally invasive. It allows stable fixation, rapid healing and a prompt return of the child to normal activity. The objective of the study was to evaluate the functional outcome of the pediatric femur shaft fractures with Ender’s intramedullary nailing.Methods: 20 patients aged 5 to 16 years with fracture shaft of the femur treated with retrograde flexible intramedullary nailing at Bapuji hospital attached to JJM Medical College, Davangere in the period from September 2014 to August 2015 were included in the study.Results: All patients were followed until fracture union occurred. The follow up period ranged from 6 months to 1 year. Results were analysed both clinically and radiologically. 1 case united within 8 weeks,14 cases in 10 weeks and 5 cases in 12 weeks. Out of 20 cases there is limb length discrepancy in 6 cases, infection in 2 cases, nail back out in 2 cases, varus malalignment in 2 cases, valgus malalingment in 3 cases, anterior angulation in 6 cases and rotational malalignment in 2 cases..Conclusions: Closed intramedullary nailing is an efficient method and does not expose the patient to an undue risk of infection or non-union. There is also no risk of limb length discrepancy and the angulation and rotational malalignment are within the acceptable limits. This safe procedure can be recommended in children with multiple injuries co-existent head injury and in age groups 5 to 16 years.

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COMBINED METHOD OF INTRAMEDULLARY NAILING AND PLATING FOR UNSTABLE FRACTURES AND NON-UNION OF THE FEMORAL SHAFT

The Kurume Medical Journal ◽

10.2739/kurumemedj.20.125 ◽

1973 ◽

Vol 20 (2) ◽

pp. 125-132

Author(s):

SEIKEI MIYAGI ◽

HIROSHI INOUE

Keyword(s):

Intramedullary Nailing ◽

Femoral Shaft ◽

Combined Method ◽

Non Union ◽

Unstable Fractures

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Effects of third fragment size and displacement on non-union of femoral shaft fractures after locking for intramedullary nailing

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2015.11.014 ◽

2016 ◽

Vol 102 (2) ◽

pp. 175-181 ◽

Cited By ~ 6

Author(s):

J.R. Lee ◽

H.-J. Kim ◽

K.-B. Lee

Keyword(s):

Intramedullary Nailing ◽

Fragment Size ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Non Union ◽

Shaft Fractures

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Infrapatellar versus suprapatellar approach for intramedullary nailing of the tibia: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02249-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Nikhil Ponugoti ◽

Branavan Rudran ◽

Amr Selim ◽

Sam Nahas ◽

Henry Magill

Keyword(s):

Intramedullary Nailing ◽

Meta Analysis ◽

Deep Infection ◽

Conventional Technique ◽

Long Term Results ◽

Non Union ◽

Post Operative Pain ◽

Significant Difference ◽

Suprapatellar Approach ◽

Secondary Procedures

Abstract Background Intramedullary nailing (IMN) is a conventional technique for the treatment of tibial shaft fractures. It has been suggested that the suprapatellar (SP) approach holds advantages over the traditional infrapatellar (IP) approach. Current literature lacks adequate data to provide robust clinical recommendations. This meta-analysis aims to determine the efficacy of infrapatellar versus suprapatellar techniques for IMN. Methods An up-to-date literature search of the Embase, Medline, and registry platform databases was performed. The search was conducted using a predesigned search strategy and all eligible literature was critically appraised for methodological quality via the Cochrane’s collaboration tool. Fluoroscopy time, operative time, pain score, knee function, deep infection, non-union and secondary operation rates were all considered. Conclusion A total of twelve studies were included in the meta-analysis. The results of this analysis show that suprapatellar nailing is associated with reduced post-operative pain scores and improved functional outcomes. The data suggest no significant difference in terms of operative times, fluoroscopy times, rates of deep infection, non-union or secondary procedures when compared to infra-patellar techniques. Further studies are required to confirm these findings and assess long-term results.

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Evaluation of Ilizarov technique in the treatment of open fractures of tibia

International Surgery Journal ◽

10.18203/2349-2902.isj20204657 ◽

2020 ◽

Vol 7 (11) ◽

pp. 3570

Author(s):

Debdulal Debnath ◽

Jihadul Islam ◽

Nazmul Huda ◽

M. A. A. Shameem

Keyword(s):

Operation Time ◽

Sports Injury ◽

Deep Infection ◽

Open Fractures ◽

Type I ◽

Ilizarov Technique ◽

Duration Of Treatment ◽

Non Union ◽

Medical College ◽

Short Time

Background: Now a day, open fracture of tibia is a common occurrence in the orthopedic treatment arena. Fundamentally, open fractures of tibia are classified into type I, II, IIIA, IIIB and IIIC. The aim of this study was to evaluate the Ilizarov technique in the treatment of open fractures of tibia.Methods: This was an observational prospective study conducted in the Department of Orthopedic Surgery, Northern International Medical College& Hospital, Dhaka, Bangladesh during the period from January 2017 to December 2017. Thirty-six (36) patients with tibial fractures were selected as the study population. This study was approved by the ethical committee of the respective medical college.Results: Out of total 36 participants, 65% were males and 35% were female. In analyzing mode of injuries, we found the highest 80.56% participants were from road accidents followed by 11.11% from sports injury and rest only 8.33% from general falls. The duration of treatment with the fixator was 12-23 weeks (average 16 weeks). In our study total 36 cases were debrided on the same day and stabilized with Ilizarov ring faxator after a period of 5 to 12 days from the date of injury. The operation time ranged from 90 minutes to 120 minutes (Mean 102±4 minutes). Conclusions: In this study no case developed deep infection, non-union or unacceptable mal-union. The construct through Ilizarov is stable and enables the patient to bear weight on the affected limb a short time after the surgery, even in cases of comminuted fractures.

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