Percutaneous antegrade nailing with reductor-T tape pin is effective and well tolerated in patients with ipsilateral multisegmental femoral shaft fractures

Objective This study was performed to investigate the efficacy and safety of percutaneous antegrade nailing with a reductor-T tape pin in the treatment of ipsilateral multisegmental femoral shaft fractures (IMFSFs). Methods Nineteen patients with IMFSFs underwent antegrade nailing with a reductor-T tape pin by percutaneous techniques. The operation time, reduction time, fluoroscopy time, blood loss, fracture union time, and complications were recorded. Results All 19 patients (100%) achieved technical success. The mean and median operation time were 62.42±16.27 and 60 (range, 40–105) minutes, respectively; the mean and median reduction time were 11.47±3.78 and 10 (range, 8–22) minutes, respectively; the mean and median fluoroscopy time were 16.63±6.10 and 15 (range, 10–35) s, respectively; and the mean and median blood loss were 185.26±62.75 and 180 (range, 110–350) mL, respectively. Additionally, all 19 patients (100%) achieved fracture union within a mean and median time of 3.95±1.75 and 3 (range, 3–9) months, respectively; most patients [n=14 (73.7%)] achieved fracture union within 3 months. No obvious complications occurred during the study. Conclusion Antegrade nailing with a reductor-T tape pin by a percutaneous technique is effective and well tolerated in patients with IMFSFs.

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A comparative evaluation of the efficacy between skeletal traction and skin traction in pre-operative management of femur shaft fractures in Korle Bu Teaching Hospital

Ghana Medical Journal ◽

10.4314/gmj.v54i3.4 ◽

2020 ◽

Vol 54 (3) ◽

pp. 146-150

Author(s):

Daniel Agbley ◽

Henry Holdbrook-Smith ◽

Yao Ahonon

Keyword(s):

Blood Loss ◽

Femoral Shaft ◽

Operative Blood Loss ◽

Skeletal Traction ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Significant Difference ◽

The Mean ◽

Traction Group ◽

Skin Traction

Objectives: This study is to compare the outcomes of pre-operative skeletal and skin traction in adult femoral shaft fractures awaiting surgical fixation within two weeks of presentation to the Accident Center of Korle Bu Teaching Hospital.Methods: This study was a clinical trial on 86 recruited patients with closed femoral shaft fractures sustained within 24 hours of presentation grouped into 2 groups. Descriptive and inferential statistics comprising frequency, percentage, Chi-square, independent sample t-test and Mann-Whitney U test were used in analysing the data.Results: Of the total number of patients involved in the study, 74% (n=64) were males and 26% (n=22) were females with a mean age of 39.49 (SD ±15). There was no statistically significant difference in the mean visual analogue scale (VAS) pain assessment between the Skin traction group and Trans-tibia skeletal traction group after traction. With regards to complications, the difference between the Skin traction group and the Skeletal traction group was statistically significant (P=0.001). Moreover, the mean blood loss compared with the open type of reduction in the Transtibia skeletal traction group was significantly less than the Skin traction group (p=0.000).Conclusion: This study has shown that both Skeletal traction and Skin traction were equally effective in controlling pre-operative pain in adult patients with femoral shaft fractures and does not affect intra-operative blood loss and postoperative management. Therefore, pre-operative Skin traction can be considered a useful and cost-effective method of maintaining alignment and pain relief in adult femoral shaft fractures.Keywords: Skin traction, Trans-tibia skeletal, reamed Intramedullary nailing, Intra-operative blood loss, Visual Analogue ScaleFunding: Personal Funding

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BONE HEALING PATTERNS OF INTERLOCKED INTRAMEDULLARY NAIL-FIXATED FEMORAL SHAFT FRACTURES: AGE-MATCHED RADIOGRAPHIC PRESENTATION OF UNION PATTERN

Journal of Musculoskeletal Research ◽

10.1142/s0218957717500105 ◽

2017 ◽

Vol 20 (02) ◽

pp. 1750010

Author(s):

Myung-Sang Moon ◽

Dong-Hyeon Kim ◽

Bong-Keun Park ◽

Min-Geun Yoon

Keyword(s):

Callus Formation ◽

Femoral Shaft ◽

Fracture Union ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Complete Fracture ◽

Sixth Decade ◽

Radiographic Presentation ◽

Periosteal Callus ◽

Eighth Decade

Design: Study on the union pattern of femoral shaft fractures after interlocked intramedullary fixation. Objective: To assess the fracture healing pattern — the so-called callus types — and its formation speed, and age influence. Setting: Orthopedic and traumatic services. Material and methods: Among all the healed femoral shaft fractures, 10 patients at least in each decade from late teens to eighth decade who were regularly followed radiographically with a certain interval upto complete fracture union were chosen. Results: All the fractures healed primarily with external periosteal callus which was followed sometimes later by intercortical uniting callus with disappearance of fracture line. Conclusion: All the nailed femoral shaft fractures healed primarily by periosteal bridging callus irrespective of age, fracture type, and use of interlocking screws, though some less external callus formation after sixth decade was observed.

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Does Open Reduction in Intramedullary Nailing of Femur Shaft Fractures Adversely Affect the Outcome? A Retrospective Study

Advances in Orthopedics ◽

10.1155/2020/7583204 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Syed Imran Ghouri ◽

Abduljabbar Alhammoud ◽

Mohammed Mubarak Alkhayarin

Keyword(s):

Intramedullary Nailing ◽

Closed Reduction ◽

Open Reduction ◽

Statistical Difference ◽

Operation Time ◽

Femoral Shaft ◽

Union Rate ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Reduction Group

Aim. This study aims to assess the results of open versus closed reduction in intramedullary nailing for femoral fractures and whether it delays union, predisposes to nonunion, or increases the rate of infection. Materials and Methods. A retrospective review of all adult patients with isolated femoral shaft fractures treated by intramedullary nailing was done. The primary outcome is union rate, and the secondary outcomes are operation time and the infection rate. Results. 110 isolated femoral shaft fractures, with 73 (66.4%) in the closed reduction group and 37 (33.6%) in the open reduction group, 90.4% males and 9.6% females, and the average age was 32.6 years. RTA is the most common cause of these injuries followed by the fall from height. The delayed union rate was 20% (22/110) with no difference between the two groups, p value 0.480, and the nonunion rate was 5.5% (6/110), and no statistical difference was observed between the two groups. The operation time was shorter in the closed groups, and no difference in the time to union was observed between two groups. No infection was found in the two groups. Conclusions. There is no statistical difference between the healing rates in closed and open reduction in femoral shaft fractures. In cases where closed reduction is difficult, it is better to open reduce the fracture if closed reduction cannot be achieved in 15 minutes, especially in polytrauma.

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Displaced femoral shaft fractures treated by antegrade nailing with the assistance of an intramedullary reduction device

International Orthopaedics ◽

10.1007/s00264-015-3036-8 ◽

2015 ◽

Vol 40 (8) ◽

pp. 1735-1739 ◽

Cited By ~ 7

Author(s):

Wei Chen ◽

Yongmin Jing ◽

Hongzhi Lv ◽

Juan Wang ◽

Zhiyong Hou ◽

...

Keyword(s):

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Antegrade Nailing

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Antegrade nailing of femoral shaft fractures combined with neck or distal femur fractures

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-003-0584-y ◽

2003 ◽

Vol 123 (10) ◽

pp. 544-550 ◽

Cited By ~ 16

Author(s):

G�venir Okcu ◽

Kemal Aktuglu

Keyword(s):

Distal Femur ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Femur Fractures ◽

Shaft Fractures ◽

Antegrade Nailing

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A Novel Closed Reduction Technique for Treating Femoral Shaft Fractures With Intramedullary Nails, Haemostatic Forceps and the Lever Principal

10.21203/rs.3.rs-113768/v1 ◽

2020 ◽

Author(s):

Wei Shui ◽

Youyin Yang ◽

Xinling Pi ◽

Gang Luo ◽

Bo Qiao ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Intramedullary Nail ◽

Operative Time ◽

Femoral Shaft ◽

Intraoperative Blood Loss ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Fracture Table ◽

Minimally Invasive Reduction

Abstract Background: Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures.Methods: A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss.Results: All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1±13.5 minutes (range, 50–100 minutes) and 6.7±1.9 minutes (range, 3–10 minutes). The fluoroscopy exposure time during the reduction process was 5–15 seconds, with an average time of 8.7±2.7 seconds. The average intraoperative blood loss was 73.5±22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months.Conclusions: Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.

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