scholarly journals Systematic review on the outcomes of poller screw augmentation in intramedullary nailing of long bone fracture

2020 ◽  
Vol 5 (3) ◽  
pp. 189-203
Author(s):  
Maria Tennyson ◽  
Matija Krkovic ◽  
Mary Fortune ◽  
Ali Abdulkarim

Various technical tips have been described on the placement of poller screws during intramedullary (IM) nailing; however studies reporting outcomes are limited. Overall there is no consistent conclusion about whether intramedullary nailing alone, or intramedullary nails augmented with poller screws is more advantageous. We conducted a systematic review of PubMed, EMBASE, and Cochrane databases. Seventy-five records were identified, of which 13 met our inclusion criteria. In a systematic review we asked: (1) What is the proportion of nonunions with poller screw usage? (2) What is the proportion of malalignment, infection and secondary surgical procedures with poller screw usage? The overall outcome proportion across the studies was computed using the inverse variance method for pooling. Thirteen studies with a total of 371 participants and 376 fractures were included. Mean follow-up time was 21.1 months. Mean age of included patients was 40.0 years. Seven studies had heterogenous populations of nonunions and acute fractures. Four studies included only acute fractures and two studies examined nonunions only. The results of the present systematic review show a low complication rate of IM nailing augmented with poller screws in terms of nonunion (4%, CI: 0.03–0.07), coronal plane malunion (5%, CI: 0.03–0.08), deep (5%, CI: 0.03–0.11) and superficial (6%, CI: 0.03–0.11) infections, and secondary procedures (8%, CI: 0.04–0.18). When compared with the existing literature our review suggests intramedullary nailing with poller screws has lower rates of nonunion and coronal malalignment when compared with nailing alone. Prospective randomized control trial is necessary to fully determine outcome benefits. Cite this article: EFORT Open Rev 2020;5:189-203. DOI: 10.1302/2058-5241.5.190040

2000 ◽  
Vol 13 (2) ◽  
pp. 327
Author(s):  
Jong Seok Park ◽  
Jae Hoon Lee ◽  
Hee Kwon ◽  
Jae Eung Yoo ◽  
Joon Min Song ◽  
...  

Author(s):  
Farzad Amouzadeh Omrani ◽  
Mohsen Elahi ◽  
Mohammad Mahdi Sarzaeem ◽  
Shahram Sayadi ◽  
Hamed Farzaneh

Background: Intramedullary nailing (IM nailing) is the standard of care for the treatment of most diaphyseal lower extremity fractures. A few studies have assessed and compared the infection rate following reamed and unreamed IM nailing in open long bone fractures. In the present study, we attempted to compare the infection rate between two procedures in open fractures of tibia. Methods: In this prospective study, we included consecutive patients suffering from open fractures of tibia (Gustilo subtypes II or IIIA) who required IM nailing. Patients younger than 16 years old, other Gustilo types (I, IIIB, and IIIC), fractures reaching to the tibial plateau articular surface, and simultaneous fractures of other bones in the extremity were excluded. All patients were followed up for one year to assess the postoperative infection rate. Results: Of 59 patients, 37 underwent reamed IM nailing and 22 underwent unreamed IM nailing. In reamed group, 4 cases (10.8%) experienced an infection requiring reoperation and antibiotic therapy, while in the unreamed group, it was 5 cases (22.7%). The difference between the groups was not statistically significant. Conclusion: Reamed and unreamed IM nailing procedures for fractures of tibia have similar outcome regarding long-term postoperative infections that require reoperation and antibiotic therapy.


1982 ◽  
Vol 17 (6) ◽  
pp. 1171
Author(s):  
Chang Uk Choi ◽  
Hak Hyun Kim ◽  
Yon II Kim ◽  
Sa Sang Chang ◽  
Jae Quk Joo

2020 ◽  
Vol 22 (3) ◽  
pp. 2521-2527
Author(s):  
Ioannis Sperelakis ◽  
Eliza Tsitoura ◽  
Chara Koutoulaki ◽  
Semeli Mastrodimou ◽  
Theodoros Tosounidis ◽  
...  

1994 ◽  
Vol 29 (3) ◽  
pp. 745
Author(s):  
Sung Keun Sohn ◽  
Seong Soo Kim ◽  
Jung Yoon Lee ◽  
Nam Jo Bae

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shaoyu Zhu ◽  
N Patrik Brodin ◽  
Madhur K Garg ◽  
Patrick A LaSala ◽  
Wolfgang A Tomé

ABSTRACT BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the dose-response relationship and risk factors associated with AVM obliteration using a systematic review and meta-analysis approach. METHODS Data were extracted from reports published within the last 20 yr. The dose-response fit for obliteration as a function of marginal dose was performed using inverse-variance weighting. Risk factors for AVM obliteration were assessed by combining odds ratios from individual studies using inverse-variance weighting. RESULTS The logistic model fit showed a clear association between higher marginal dose and higher rates of obliteration. There appeared to be a difference in the steepness in dose-response when comparing studies with patients treated using Gamma Knife radiosurgery (Elekta), compared to linear accelerators (LINACs), and when stratifying studies based on the size of treated AVMs. In the risk-factor analysis, AVM obliteration rate decreases with larger AVM volume or AVM diameter, higher AVM score or Spetzler-Martin (SM) grade, and prior embolization, and increases with compact AVM nidus. No statistically significant associations were found between obliteration rate and age, sex, prior hemorrhage, prior aneurysm, and location eloquence. CONCLUSION A marginal dose above 18 Gy was generally associated with AVM obliteration rates greater than 60%, although lesion size, AVM score, SM grade, prior embolization, and nidus compactness all have significant impact on AVM obliteration rate.


2021 ◽  
Vol 28 ◽  
pp. 39-46
Author(s):  
Ina Lackner ◽  
Birte Weber ◽  
Melanie Haffner-Luntzer ◽  
Simona Hristova ◽  
Florian Gebhard ◽  
...  

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