Skeletal Traction Versus External Fixation in the Initial Temporization of Femoral Shaft Fractures in Severely Injured Patients

2010 ◽  
Vol 68 (3) ◽  
pp. 633-640 ◽  
Author(s):  
Brian P. Scannell ◽  
Norman E. Waldrop ◽  
Howell C. Sasser ◽  
Ronald F. Sing ◽  
Michael J. Bosse
Keyword(s):  
External Fixation ◽  
Femoral Shaft ◽  
Severely Injured ◽  
Severely Injured Patients ◽  
Skeletal Traction ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Injured Patients

scholarly journals The experiences of adult patients receiving treatment for femoral shaft fractures at Kamuzu Central Hospital, Malawi: a qualitative analysis

2020 ◽  
Author(s):  
Kiran Jay Agarwal-Harding ◽  
Louise Atadja ◽  
Linda Chokotho ◽  
Leonard Ngoie Banza ◽  
Nyengo Mkandawire ◽  
...  
Keyword(s):  
Health System ◽  
Operative Treatment ◽  
Financial Burden ◽  
Femoral Shaft ◽  
Central Hospital ◽  
Structured Interviews ◽  
Skeletal Traction ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Kamuzu Central Hospital

Abstract Background: There is a growing burden of musculoskeletal trauma in Malawi, and a lack of surgical capacity to manage common, debilitating injuries like femoral shaft fractures (FSFs). Non-operative treatment with skeletal traction remains the standard of care, with surgery available only at central hospitals. Patients experience myriad barriers to care, which can result in delayed treatment and complications. We sought to understand how patients navigate the Malawian health system and the barriers they face while seeking care. Methods: We performed in-depth, semi-structured interviews of 15 adults with closed FSFs during their inpatient hospitalization at Kamuzu Central Hospital (KCH), a public referral hospital in Lilongwe, Malawi. We additionally interviewed one patient who left KCH to seek care at a private hospital. An English-speaking study investigator performed all interviews accompanied by a Chichewa-speaking medical interpreter. Interviews focused on patients’ pathways from injury to present treatment (health system navigation); impressions of the hospital and care received; and the effects of injury/treatment on patients and their families. Interviews were audio-recorded, translated, and transcribed in English. We coded the transcripts and performed a thematic analysis. Results: We identified 6 themes: high variability in health system navigation; frustrations with the biopsychosocial effects of hospitalization; lack of participation in decision-making and uncertainty about treatment course; preference for surgery (vs. traction) based on patients’ own experiences and observations; frustrations with the inequitable provision of surgery ; and patients’ resignation, acceptance, and resilience in the face of hardship. Many patients receiving non-operative treatment described the devastating financial burden imposed upon them and their families by their injury and prolonged hospitalization. They felt they were receiving inferior treatment compared to surgery and suspected that richer patients were receiving more timely care. Conclusion: This qualitative study suggests a need to standardize care for FSF in Malawi, increase availability and timeliness of surgery, and increase transparency and communication between providers and patients. These remedies should focus on improving quality of care and achieving equity in access to care.

Treatment Of Femoral Shaft Fractures In Children With External Fixation

2017 ◽  
pp. 1
Author(s):  
Mustafa El Fadli ◽  
Mabrouk Bohalfaya ◽  
Aboagela A. Raheem ◽  
Mohamed Khalil ◽  
Salah Bowina
Keyword(s):  
External Fixation ◽  
Femoral Shaft ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Fractures In Children

A Comparative Study between Intramedullary Fixation and External Fixation of Femur Shaft Fracture in Polytrauma Patients in Jharkhand

2021 ◽  
Vol 8 (32) ◽  
pp. 2933-2937
Author(s):  
Supantha Panja
Keyword(s):  
Comparative Study ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Complication Rate ◽  
Gold Standard ◽  
Femoral Shaft ◽  
High Energy ◽  
Definitive Treatment ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

BACKGROUND Femoral shaft fractures result from high energy trauma and maybe associated with life threatening conditions. Typical in younger people is associated with polytrauma. Though intramedullary nailing (IMN) is the gold standard option of treatment, external fixation (EF) can also be used temporarily or definitively, in such cases. The aim of this study was to compare the functional outcome of these two procedures. METHODS This prospective comparative study was conducted at our centre over a period of 6 years. Age, sex of the patients, laterality, type of fracture with mean follow up, union time, and complications such as delayed union, angular deformities, and limb length discrepancies were tabulated and compared. RESULTS There were more cases of open fractures in the EF group compared to IMN group. In the IMN group the average surgery duration was 95.76 minutes and it was 69.4 minutes in the EF group. The average time for bone union was 25.66 weeks in IMF group and 28.22 weeks in EF group. Complication rate was higher in EF group with 11 complications (7 major & 4 minor) compared to IMN group with only 6 cases presenting with complications (3 each of major & minor). CONCLUSIONS Though IMN is the gold standard in treatment of femoral shaft fractures, EF in polytrauma is an alternative method for definitive fracture stabilization, with minimal additional operative trauma and an acceptable complication rate. KEYWORDS Femoral Shaft Fractures, Intramedullary Nailing, External Fixation, Polytrauma, Definitive Treatment

scholarly journals Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation

2019 ◽  
Vol 8 (8) ◽  
pp. 1119 ◽  
Author(s):  
Gianluca Testa ◽  
Andrea Vescio ◽  
Domenico Costantino Aloj ◽  
Giacomo Papotto ◽  
Luigi Ferrarotto ◽  
...  
Keyword(s):  
External Fixation ◽  
Intramedullary Nailing ◽  
Gold Standard ◽  
Femoral Shaft ◽  
Bone Union ◽  
Definitive Treatment ◽  
Ao Classification ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Background: Femoral shaft fractures result from high-energy trauma. Despite intramedullary nailing (IMN) representing the gold standard option of treatment, external fixation (EF) can be used temporarily for damage control or definitively. The purpose of this study is to compare two different options, anterograde IMN and monoaxial EF, for the treatment of femoral shaft fractures. Methods: Between January 2005 and December 2014, patients with femoral shaft fractures operated on in two centers were retrospectively evaluated and divided into two groups: the IMN group (n = 74), and the EF group (n = 73). For each group, sex; laterality; age; and AO classification type mean follow-up, mean union time, and complications were reported. Results: Both groups were found to have no statistical differences (p > 0.05) in sex, laterality, age, and AO classification types. In the IMN group the average surgery duration was 79.7 minutes (range 45–130). The average time for bone union was 26.9 weeks. Major complications occurred in 4 (5.4%) patients. In the EF group the average follow-up duration was 59.8 months (range 28–160). The average time for bone union was 24.0 weeks. Major complications occurred in 16 (21.9%) patients. Conclusions: IMN is the gold standard for definitive treatment of femoral shaft fractures. In patients with severe associated injuries, EF should be a good alternative.

Sign in / Sign up

Export Citation Format

Share Document