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.

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.

A Comparison of Complications and Union Rates in Intramedullary Nailing of Femoral Shaft Fractures Treated With Open Versus Closed Reduction

Orthopedics ◽  
2019 ◽  
Vol 43 (2) ◽  
pp. 103-107
Author(s):  
Zachary L. Telgheder ◽  
Matthew A. Albanese ◽  
David S. Bloom ◽  
Swamy Kurra ◽  
Matthew P. Sullivan
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Femoral Shaft ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Open Versus

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

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.

scholarly journals Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children

2017 ◽  
Vol 13 (3) ◽  
pp. 195-199
Author(s):  
J.A. Khan ◽  
G.P. Singh ◽  
A. Pandey
Keyword(s):  
Range Of Motion ◽  
Intramedullary Nailing ◽  
Femoral Shaft ◽  
Limb Length Discrepancy ◽  
Elastic Stable Intramedullary Nailing ◽  
Limb Length ◽  
Femoral Shaft Fractures ◽  
Length Discrepancy ◽  
Shaft Fractures ◽  
Fractures In Children

Background Femoral-shaft fractures are among the most common fractures of the lower extremity in children. There are several different options for treating femoral-shaft fractures in children. Elastic stable intramedullary nailing (ESIN) has become the standard treatment for fractures of shaft of femur in children for reasons including mini-invasive surgery, no need for casting, early mobilization and discharge as well as growing concerns toward cost-effectiveness.Objective To demonstrate the effectiveness of intramedullary fixation of fracture shaft of femur in skeletally immature children using the titanium elastic intramedullary nails.Method Forty children who underwent fixation with titanium intramedullary nails because of fracture of shaft of femur (Winquist and Hansen type 1 and 2) were reviewed. There were 60% male and 40% female patients and mean follow-up was six months. Time of union, deformity at fracture site, limb length discrepancy, knee range of motion and complications were assessed.Result Average age of the patients was 5.17 years (range 3 to 10). All patients achieved complete healing at a mean 12.8 weeks (range 10 to 20 weeks). Average limb length discrepancy was -0.16 cm (range -1.0 to 1.1 cm) average knee range of motion was 137.55 degrees (range 118 to 152 degrees). Complications were recorded in 13 (31.7%) patients and included: Five malunion which did not show any deformity or functional impairment and eight superficial wound infections which were healed after removal of nail. All patients were active as their pre injury levels at six months follow up.Conclusion Elastic stable intramedullary nailing is the method of choice for the simple pediatrics fracture shaft of femur, as it is minimally invasive and shows good functional and cosmetic results. It allows short hospital stay and quick recovery from pain and is cast-free.

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 Titanium elastic nailing for paediatric femoral shaft fractures: a prospective descriptive study

2017 ◽  
Vol 3 (3) ◽  
pp. 501
Author(s):  
Santosha . ◽  
Shams Gulrez
Keyword(s):  
Closed Reduction ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Technical Problems ◽  
Femoral Shaft Fractures ◽  
Titanium Elastic Nailing ◽  
Shaft Fractures ◽  
Fractures In Children ◽  
Early Return ◽  
Diaphyseal Fractures

<p class="abstract"><strong>Background:</strong> Femoral shaft fracture is the most common major paediatric orthopaedic fractures. For generations traction and casting was the standard treatment for all femoral shaft fractures in children. Over the past two decades the advantages of fixation and rapid mobilisation have been increasingly recognised. Aim: To assess the functional and clinical outcome after closed reduction and internal fixation with titanium elastic nail in diaphyseal femoral fractures between 5 to 16 years.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of Orthopaedic Surgery, Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from September 2013 to April 2015. Thirty children (20 boys and 10 girls) in the age group of 5 to 16 years with recent femoral diaphyseal fractures were stabilised by titanium elastic nails [TENS]. Results were evaluated according to Flynn’s scoring criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> After 25 months of follow up all thirty patients were available for evaluation. Radiological union were achieved in a mean time of 11.5 weeks. Mean duration of hospital stay was 15.23 days. According to Flynn’s criteria of TENS outcome score results were excellent in 66.7% patients, Satisfactory in 30% patients, Poor in 3.3% patient. All patients had early return to school. Per operative technical problems included failure of closed reduction in 2 cases.</p><p><strong>Conclusions:</strong> Titanium elastic nailing is an effective treatment in diaphyseal fractures of femur in properly selected patients. </p>

scholarly journals Adverse Events following Intramedullary Nailing in Metastatic Pathological versus Non-Pathological Femoral Shaft Fractures: A Retrospective Comparative Study

2021 ◽  
Author(s):  
Chirathit Anusitviwat ◽  
Khanin Iamthanaporn ◽  
Pakjai Tuntarattanapong ◽  
Boonsin Tangtrakulwanich ◽  
Tippawan Liabsuetrakul
Keyword(s):  
Regression Analysis ◽  
Adverse Events ◽  
Intramedullary Nailing ◽  
Multivariate Logistic Regression Analysis ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Multivariate Regression Analysis ◽  
Pathological Fractures ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Abstract Background: Antegrade intramedullary nailing is indicated for treating metastatic pathological femoral shaft fractures. Although good functional outcomes could be obtained from internal fixation, postoperative adverse events have been reported in patients with pathological fractures and non-pathological fractures. Not only adverse events but also their consequences including, readmission and reoperation, need to be considered. Few studies have assessed the risk of postoperative adverse events, reoperation, and readmission without comparison. Therefore, this study aimed to compare the risk of in-hospital adverse events and consequences after discharge between patients with metastatic pathological and non-pathological femoral fractures undergoing intramedullary nailing.Methods: We conducted a retrospective study by extracting records from the Hospital Information System database. We accessed patients with pathological metastatic pathological and non-pathological femoral shaft fractures undergoing intramedullary nailing by the International Classification of Diseases code; from June 2006 to 2020. We then tracked the in-hospital medical and surgical adverse events postoperatively, along with the consequences after discharge. The in-hospital adverse events risk between the two groups of patients were analyzed and compared by multivariate logistic regression analysis.Results: Included patients consisted of 48 in pathological groups and 185 in non-pathological groups. Significantly higher rates of surgical and medical adverse events in patients with pathological fractures compared to patients with non-pathological fractures were observed. After adjusting for potential confounding factors in multivariate regression analysis, patients with pathological fractures had higher odds of both adverse surgical (adjusted OR 2.43, 95% CI 1.15 - 5.13) and medical adverse events (adjusted OR 2.81, 95% CI 1.13 - 7.03).Conclusions: Patients with metastatic pathological femoral shaft fractures undergoing intramedullary nailing were more likely to experience postoperative adverse events than patients with non-pathological fractures.

scholarly journals Application of a Custom-designed External Fixation Restorer for Pediatric Femoral Fractures

2021 ◽  
Author(s):  
Yuchang Liu ◽  
Jia-Yu Yuan ◽  
Chunfang Li ◽  
Xinjian Pei ◽  
Yazhou Li
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Psychological Impact ◽  
Femoral Fractures ◽  
Femoral Shaft ◽  
Partial Fracture ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Increased Risk ◽  
New Type

Abstract Background: Closed reduction of pediatric femoral shaft fractures is one of the most difficult types of partial fracture reductions. Open reduction increases the harm to children. Although smaller invasive open reduction is mostly used at present, it has an impact on the microenvironment around the fracture and results in increased intraoperative bleeding, an increased risk of postoperative infection and surgical scarring, which has a great psychological impact on children. Methods: Given the above challenges, we propose another intraoperative reduction method. The technique described involves closed reduction and internal fixation for pediatric femoral shaft fractures using a new type of intraoperative fixator. Result: This technique brings hope that the success rate of closed reduction for pediatric femoral shaft fractures can reach 100%. Conclution: The method is demonstrated in a patient.

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