Closed intramedullary nailing of acute femoral shaft fracture: reduction with help of bone levers through a small incision without opening fracture site

Background: Femoral shaft fractures are usually treated with intramedullary nailing. In this study, we report a modified closed surgical technique with reduction with bone levers through a small percutaneous stab incision without opening fracture site for this type of fracture.Methods: From June 2015-January 2017, this technique was used on 43 patients with femoral shaft fractures. Patients were followed up postoperatively for clinical evaluation. The surgical technique involves a mini-percutaneous incision slightly distal to the fracture site, and fracture reduction is performed with bone levers without opening the fracture site.Results: 39 patients were included in final assessment. 29 fractures (74.4%) healed in the first 6 month. 35 (89.7%) fractures were united by one year. 4 (10.3%) patients needed bone grafting. The functional results were considered excellent and good in 36 (92.3%) patients, 3 (7.7%) patients had poor results.Conclusions: The advantages of this procedure include that no fracture site is opened, there is a shorter operation time, less radiation exposure and it is especially suitable for multiple trauma and obese patients.

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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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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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Intramedullary nailingin femoral shaft fractureFemoral shaft fracture, intramedullary nailing of27 Intramedullary Nailing of Femoral Shaft Fractures

Key Techniques in Orthopaedic Surgery ◽

10.1055/b-0038-162540 ◽

2018 ◽

Keyword(s):

Intramedullary Nailing ◽

Femoral Shaft ◽

Shaft Fracture ◽

Femoral Shaft Fractures ◽

Shaft Fractures

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Intramedullary nailing of abnormally bowed atypical femoral shaft fractures: surgical technique

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-019-03279-4 ◽

2019 ◽

Vol 140 (3) ◽

pp. 353-357 ◽

Cited By ~ 1

Author(s):

Mark Tan ◽

James Wei Xuan Siow ◽

Ernest Beng Kee Kwek

Keyword(s):

Surgical Technique ◽

Intramedullary Nailing ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures

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A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20160711 ◽

2016 ◽

Vol 2 (1) ◽

pp. 18 ◽

Cited By ~ 1

Author(s):

Kanta Prasad Meena ◽

Mahendra Kumar Yadav ◽

Deepak Devatheya

Keyword(s):

Functional Outcome ◽

Femoral Shaft ◽

Shaft Fracture ◽

Fracture Site ◽

Entry Point ◽

Greater Trochanter ◽

Femoral Shaft Fractures ◽

Femoral Nailing ◽

Shaft Fractures ◽

Significant Difference

Background: In case of close nailing for femoral shaft fractures, the nail is inserted into the medullary cavity through the proximal femur without disturbing the periosteal blood supply of at the fracture site. The piriformis fossa and greater trochanter has been commonly described as starting points for antegrade femoral nailing. The purpose of this study was to compare results of two entry ports being used for intramedullary nailing for femoral shaft fractures.Methods: This study was conducted during a period of one year. The patients admitted with femoral diaphyseal fractures for antegrade nailing were divided in two groups alternatively for piriformis fossa entry point and greater trochanter entry point. Total number of patient in each group was 25 (n = 25). Functional outcome were analyzed at final follow up using Hari’s hip score.Results: There was no significant difference clinical and functional output in both group but intraoperative time and fluoroscopic time was significant (P <0.001).Conclusions: Femoral nailing through the greater trochanter entry portal with specifically designed nails should be considered a rational alternative to femoral nailing compared to Piriformis fossa entry portal with the benefit of reduced requirement for fluoroscopy and decreased operative time in obese patients. Statistically no significant difference (>0.005) in clinical and Functional outcome based on Hari’s hip score.

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