scholarly journals A study on role of intramedullary interlocking nailing in the complex femoral shaft fractures

2019 ◽  
Vol 5 (5) ◽  
pp. 843
Author(s):  
Veera Kumaran ◽  
Sachidhanandham .
Keyword(s):  
Weight Bearing ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
High Energy ◽  
Rotational Stability ◽  
Full Weight Bearing ◽  
Care Hospital ◽  
Femoral Shaft Fractures ◽  
Interlocking Nailing ◽  
Shaft Fractures

<p class="abstract"><strong>Background:</strong> Fractures of the shaft of the femur are a major cause of morbidity and mortality in patients who sustain high energy trauma. Morbidity arises from limb shortening, malalignment, knee contractures and other complications of fracture.</p><p class="abstract"><strong>Methods:</strong> The aim of our study is to analyze the results of complex femoral shaft fractures treated by intramedullary interlocking nailing in our institution. Totally 20 cases of complex femoral fractures from 2007-2009 were treated with intramedullary interlocking at Krishanakumar Orthopedic Care Hospital, Nagercoil were included in our study.<strong></strong></p><p class="abstract"><strong>Results:</strong> We found that fracture of femur is most common in 2nd, 3rd and 4th decade of life, with mean age of 35.85 years. Vehicular accident in 17 patients was observed to be the main cause of fracture in our series (85%). 4 patients started full weight bearing at 10th week, 9 patients were able to bear full weight at 12th week, 4 patients at 14th week and 2 at 16th week. Average time of full weight bearing was 12.4 weeks. One patient developed deep infection (osteomyelitis) at 12 weeks and later non union was seen and unable to bear full weight.</p><p class="abstract"><strong>Conclusions:</strong> Intramedullary interlocking nailing for complex femoral fractures has been established worldwide as the gold standard treatment because of its load sharing property, internal splinting, and rotational stability. These contribute the stable osteosynthesis.</p><p class="abstract"> </p>

scholarly journals The Epidemiology of Adult Distal Femoral Shaft Fractures in a Central London Major Trauma Centre Over Five Years

2017 ◽  
Vol 11 (1) ◽  
pp. 1277-1291 ◽  
Author(s):  
Akib Majed Khan ◽  
Quen Oat Tang ◽  
Dominic Spicer
Keyword(s):  
Major Trauma ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
High Energy ◽  
Locking Plates ◽  
Mechanism Of Injury ◽  
Femoral Shaft Fractures ◽  
Technical Requirements ◽  
Shaft Fractures ◽  
Major Trauma Centre

Background:Distal femoral fractures account for 3-6% of adult femoral fractures and 0.4% of all fractures and are associated with significant morbidity and mortality rates. As countries develop inter-hospital trauma networks and adapt healthcare policy for an aging population there is growing importance for research within this field.Methods:Hospital coding and registry records at the central London Major Trauma Center identified 219 patients with distal femoral shaft fractures that occurred between December 2010 and January 2016. CT-Scans were reviewed resulting in exclusion of 73 inappropriately coded, 10 pediatric and 12 periprosthetic cases. Demographics, mechanism of injury, AO/OTA fracture classification and management were analyzed for the remaining 124 patients with 125 fractures. Mann Whitney U and Chi Squared tests were used during analyses.Results:The cases show bimodal distribution with younger patients being male (median age 65.6) compared to female (median age 71). Injury caused through high-energy mechanisms were more common in men (70.5%) whilst women sustained injuries mainly from low-energy mechanisms (82.7%) (p<0.0001). Majority of fractures were 33-A (52.0%) followed by 33-B (30.4%) and 33-C (17.6%). Ninety-two (73.6%) underwent operative management. The most common operation was locking plates (64.1%) followed by intramedullary nailing (19.6%).Interpretation:The epidemiology of a rare fracture pattern with variable degrees of complexity is described. A significant correlation between biological sex and mechanism of injury was identified. The fixation technique favored was multidirectional locking plates. Technical requirements for fixation and low prevalence of 33-C fractures warrant consideration of locating treatment at centers with high caseloads and experience.

scholarly journals Management of compound fractures of shaft femur: a study of 55 cases

2016 ◽  
Vol 2 (4) ◽  
pp. 313
Author(s):  
Gaurav Singla ◽  
Amita Aggarwal ◽  
Ravinder Singh
Keyword(s):  
Femoral Shaft Fracture ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Deep Infection ◽  
Full Weight Bearing ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Mean Time

<p class="abstract"><strong>Background:</strong> Compound femoral shaft fractures are a major cause of morbidity and mortality. Conservative treatment necessitates a long stay in hospital for traction and subsequent immobilization and chances of wound infection are much higher. The objective of this study was to find out the outcome of treatment of open femoral shaft fractures by various modalities like interlocked nailing, plating and external fixation<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Fifty five patients with open femoral shaft fractures were treated under spinal or general anaesthesia. These fractures were in proximal one third (n=3), middle third (n=29), distal third (n=21). Fifty patients underwent surgery within 5 days of injury. Patients were followed for a minimum of 12 Months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients achieved union in an average time of 20 weeks (range 17 to 24 weeks). Full weight bearing was started in a mean time of 16 weeks. Mean duration of hospital stay was 20 days. Complications were occurred in ten patients (4 non-unions and 3 patients with deep infection and 3 patients developed chronic osteomyelitis)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The results were excellent in 31, good in 13, fair in 3 and poor in 7 patients while one patient lost follow up as he was from far off place. We concluded that open femoral shaft fracture can be well managed by surgical intervention<span lang="EN-IN">.</span></p>

scholarly journals TENS for the surgical management of femoral shaft fractures in 6-14 years age group children

2017 ◽  
Vol 5 (2) ◽  
pp. 13-21
Author(s):  
Mohit Khanna ◽  
Jitendra Wadhwani ◽  
Amit Batra ◽  
Sidharth Yadav ◽  
Sarfraz Iman ◽  
...  
Keyword(s):  
Prospective Study ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Full Weight Bearing ◽  
External Fixators ◽  
Age Group ◽  
Femoral Shaft Fractures ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Fractures In Children

Background. Fracture shaft of femur in pediatric age group is one of the most common leading emergencies. Children in the age group of 6-14 years are treated with either traction, hip spica, flexible/elastic stable retrograde intramedullary nail, or external fixators. We conducted a clinical prospective study on the use of Titanium Elastic Nailing System (TENS) for the treatment of femoral shaft fractures in children. Methods. The prospective study included 45 cases of fresh femoral shaft fractures. The Inclusion Criteria were a) Age group of 6-14 years, b) Recent fracture of femur shaft c) Transverse, short oblique, minimally comminuted fractures. Results. The clinical results were evaluated using Flynn’s criteria of scoring as, Excellent in 40 patients (88.89 %), Satisfactory in 5 patients (11.12 %) and poor in none. Radiological criteria for fracture union were assessed by using Anthony et al scale. Nine patients developed bursitis at entry point of the nail. Three patients had superficial infection due to bursitis. Full weight bearing was possible in mean time of 8.7 weeks (range; 7-12 weeks). Conclusion. TENS is very effective in management of paediatric shaft femur fractures in the age group of 6-14 years with advantages of early union, early mobilization and manageable complications.

scholarly journals Treatment of closed femoral shaft fractures in children aged 2–10 years: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Stijn van Cruchten ◽  
Eefke C. Warmerdam ◽  
Dagmar R. J. Kempink ◽  
Victor A. de Ridder
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Treatment Modalities ◽  
Full Weight Bearing ◽  
Femoral Shaft Fractures ◽  
Spica Casting ◽  
Shaft Fractures ◽  
Fractures In Children

Abstract Objective To review current literature on treatment of closed femoral shaft fractures in children of 2–10 years old, with subgroup analysis of children aged 2–6 years, comparing intramedullary nailing (IMN) to conservative treatment modalities. Methods We included clinical trials and observational studies that compared traction and subsequent casting (TSC), spica casting and IMN for treatment of femur shaft fractures in children of 2–10 years of age. Subgroup analysis of children aged 2–6 years was performed. Results Compared to treatment with immediate spica casting, IMN led to significantly less coronal angulation (mean difference (MD): 2.03 degrees, confidence interval (CI) 1.15–2.90), less sagittal angulation (MD: 1.59 degrees, CI 0.82–2.35) and lower rates of LLD (Risk difference (RD): 0.07, CI 0.03–0.11). In terms of rehabilitation, IMN leaded to shorter time until walking with aids (MD: 31.53 days, CI 16.02–47.03), shorter time until independent ambulation (MD: 26.59 days, CI 22.07, 31.11) and shorter time until full weight bearing (MD: 27.05 days, CI 6.11, 47,99). Compared to TSC, IMN led to a lower rate of malunion (RD: 0.31, CI 0.05–0.56), shorter hospital stays (MD: 12.48 days, CI 11.57, 13.39), time until walking with aids (MD: 54.55, CI 40.05–69.04) and full weight bearing (MD: 27.05 days [6.11, 47,99]). Conclusion Although a lack of quality evidence, this systematic review showed a clear tendency to treatment with elastic intramedullary nails of femoral shaft fractures in children of 2–10 years of age. Level of evidence 3.

scholarly journals Comparison of Atypical and Osteoporotic Femoral Shaft Fractures in the Elderly: A Multicenter Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Takanori Miura ◽  
Hiroaki Kijima ◽  
Noriyuki Ishikawa ◽  
Toshihito Ebina ◽  
Takayuki Tani ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Bone Healing ◽  
Plate Fixation ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
High Energy ◽  
Healing Time ◽  
Atypical Femoral Fractures ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Background. In atypical femoral fractures, owing to the high rates of complications and delayed healing that accompany the plate fixation, the most favorable treatment is intramedullary nailing. Although there is insufficient evidence, plate fixation is chosen due to anterolateral bowing of the femur. This study compared the bone healing time and rates of complications in atypical femoral shaft fractures and osteoporotic femoral shaft fractures. Methods. We searched the medical records of 3 institutions in Japan for patients with femoral shaft fractures who visited between 1 January 2010 and 31 December 2015. We identified 65 patients and excluded 37 among these due to high-energy injuries or being younger than 65 years. Among the remaining patients, we identified 17 and 11 women with atypical (AFF group) and osteoporotic femoral shaft fractures (OP group), respectively. Results. In surgical method, there were differences in intramedullary nailing (94.1% versus 27.2%) (p<0.01). The mean bone healing time was 11.1 months versus 6.7 months in 2 groups (p<0.01). Iatrogenic femoral fractures during intramedullary nail insertion were observed in both groups, and reoperation was only seen in atypical femoral fractures treated with a plate fixation, but there was no difference in the rate of complications (23.5% versus 9.1%). Conclusions. In the atypical femoral fracture group, intramedullary nailing was more chosen, but the bone healing time was delayed and plate fixation cases needed reoperation. There was no significant difference in the rate of complications between the 2 groups.

scholarly journals Comparative study of titanium elastic nailing versus hip spica in treatment of femoral shaft fractures in children

2016 ◽  
Vol 2 (3) ◽  
pp. 154 ◽  
Author(s):  
Dharam Pal Verma ◽  
Rahul Kumar Chandan ◽  
R. C. Meena ◽  
S. L. Sharma
Keyword(s):  
Weight Bearing ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Delayed Union ◽  
Spica Cast ◽  
Femoral Shaft Fractures ◽  
Titanium Elastic Nailing ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Hip Spica Cast

<p class="abstract"><strong>Background:</strong> There is no consensus on treatment of closed femoral-shaft fractures in children. We compared hip spica cast with titanium elastic nailing (TEN) in the treatment of femoral-shaft fractures in children.</p><p class="abstract"><strong>Methods:</strong> Study was conducted at SMS Medical College, Jaipur (Rajasthan). Out of 90 Patients of diaphyseal fracture femur, 45were treated conservatively by spica cast and 45 were treated with TEN. Follow up done regularly up to twelve months of injury with taking into account, various parameters.<strong></strong></p><p class="abstract"><strong>Results:</strong> All diaphyseal fractures of femur healed, whether treated conservatively by spica cast or treated operatively with TEN. The time of union and weight bearing was less in operative group as comparative to spica cast group. Ten patients (22.22%) in spica group compared to three patients (6.66%) in operative group had malunion and two patients (4.4%) in spica group compared none in operative group had delayed union.</p><p><strong>Conclusions:</strong> Results of TEN turned out to be far superior to traction and spica cast treatment in paediatric femoral fractures. Rate of complications was far low with operative than conservative Treatment.</p>

scholarly journals The design of an “H” joystick for closed reduction and its application in segmental and comminuted femoral shaft fractures: an innovative technique

2020 ◽  
Author(s):  
Zhaofeng Jia ◽  
Shijin Wang ◽  
Tinghui Xiao ◽  
Wei Jiang ◽  
Tianjian Zhou ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Lateral Displacement ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Bony Union ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Lateral Displacements

Abstract Background: Closed reduction and locked intramedullary nailing has become a common surgical method in the treatment of femoral shaft fractures. Overlap and rotation displacements can usually be corrected through the use of an orthopaedic traction table. However, lateral displacement and angulation persist. Methods: In this paper, we describe a joystick that can be used in the closed reduction of a fracture. It can correct lateral displacement and angulation and has the advantage of multi-direction reduction. The device described in this paper includes two parallel horizontal joysticks, one vertical main joystick and four assistant rods. Moreover, there are many specific spacing holes in the two parallel horizontal joysticks and a groove structure in the vertical main joystick. When the main “H” joystick is pressed, it can adjust lateral displacements and angulation because of the lever principle. The distance between parallel horizontal joysticks and assistant rods can be adjusted to the fracture position and body mass index of different patients. Results: The study participants consisted of 11 males and 5 females with a mean age of 31.0 years. All participants had good closed reduction and achieved bony union without any complications such as infection, nerve injury, nonunion, malunion and limb length discrepancy. By using an “H” joystick, closed femoral shaft fracture reduction and locked intramedullary nailing becomes simpler and faster. Conclusion: Based on the use of this instrument, we can easily and conveniently obtain the correct reduction situation, which leads to better surgical results. This device can be applied in the reduction of clinical femoral fractures and gradually extended to the reduction of other fractures.

Sign in / Sign up

Export Citation Format

Share Document