scholarly journals Safety and Efficacy of the META-TAN in Femoral Shaft Fractures: A Retrospective Case Series of 33 Patients

2020 ◽  
Author(s):  
Jorge Clint De Leon ◽  
Khang H Dang ◽  
Cooper Benjamin Tye ◽  
Connor Scott Breinholt ◽  
Ravi A. Karia
Keyword(s):  
Failure Rate ◽  
Demographic Data ◽  
Case Series ◽  
Femoral Shaft ◽  
High Energy ◽  
Implant Failure ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Femur Shaft ◽  
Femur Shaft Fractures

Abstract Introduction: Despite advances in femoral shaft fracture fixation, the nonunion rate remains relatively high; and there is limited data on the efficacy and failure rate of specific implants. The Smith & Nephew TRIGEN META-TAN provides the ability to treat femur shaft fractures in isolation, with associated ipsilateral femur injuries, and provides various options for proximal and distal fixation. The aim of this study is to evaluate the early failure rate of the META-TAN, while comparing the nonunion rate to what is currently presented in the literature. This study is the first of its kind in evaluation of a specific implant for treatment of femoral shaft fractures and ipsilateral pathology.Material and Methods: Patients over 18 years of age, with traumatic femur shaft fractures, treated with the META-TAN and available for a minimum of 3-month follow-up were included for analysis. Data was collected by retrospective chart review and review of existing radiographs. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation.Results: Of the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months. Conclusion: The nonunion rate of the META-TAN nail is comparable to what is reported in the literature. The META-TAN is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.

scholarly journals Safety and efficacy of a novel cephalomedullary nail femoral shaft fractures: a retrospective observational cohort in 33 patients

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Jorge C. De Leon ◽  
Cooper B. Tye ◽  
Connor S. Breinholt ◽  
Khang H. Dang ◽  
Ravi A. Karia
Keyword(s):  
Failure Rate ◽  
Femoral Shaft ◽  
High Energy ◽  
Implant Failure ◽  
Cephalomedullary Nail ◽  
Safety And Efficacy ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Femur Shaft ◽  
Femur Shaft Fractures

Abstract Background Despite advances in femoral shaft fracture fixation, the nonunion rate remains relatively high; and there is limited data on the efficacy and failure rate of specific implants. A novel cephalomedullary nail provides the ability to treat femur shaft fractures in isolation, with associated ipsilateral femur injuries, and provides various options for proximal and distal fixation exists on the market; but literature remains limited on the safety and efficacy of this implant. The aim of this study is to evaluate the early failure rate of this cephalomedullary nail, while comparing the nonunion rate to what is currently presented in the literature. This study is the first of its kind in evaluation of a specific implant for treatment of femoral shaft fractures and ipsilateral pathology. Methods Patients over 18 years of age, with traumatic femur shaft fractures, treated with this particular cephalomedullary nail and available for a minimum of 3-month follow-up were included for analysis. Data was collected by retrospective chart review and review of existing radiographs. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation. Results Of the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months. Conclusion The nonunion rate of this novel cephalomedullary nail is comparable to what is reported in the literature. This nail is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.

scholarly journals Safety and efficacy of a novel cephalomedullary nail in femoral shaft fractures: a retrospective observational cohort in 33 patients

2020 ◽  
Author(s):  
Jorge Clint De Leon ◽  
Cooper Benjamin Tye ◽  
Connor Scott Breinholt ◽  
Khang H Dang ◽  
Ravi A. Karia
Keyword(s):  
Failure Rate ◽  
Femoral Shaft ◽  
Implant Failure ◽  
Cephalomedullary Nail ◽  
Safety And Efficacy ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Observational Cohort ◽  
Femur Shaft ◽  
Femur Shaft Fractures

Abstract Background: Despite advances in femoral shaft fracture fixation, the nonunion rate remains relatively high; and there is limited data on the efficacy and failure rate of specific implants. A novel cephalomedullary nail that provides the ability to treat femur shaft fractures in isolation, with associated ipsilateral femur injuries, and provides various options for proximal and distal fixation exists on the market; but little is available on the safety and efficacy of this implant. The aim of this study is to evaluate the early failure rate of this cephalomedullary nail, while comparing the nonunion rate to what is currently presented in the literature. This study is the first of its kind in evaluation of a specific implant for treatment of femoral shaft fractures and ipsilateral pathology.Methods: Patients over 18 years of age, with traumatic femur shaft fractures, treated with this novel cephalomedullary nail and available for a minimum of 3-month follow-up were included for analysis. Retrospective chart review for this retrospective observational cohort study was performed. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation. We hypothesize that the union and failure rate will be similar to that reported in the literature for femur shaft fractures.Results: Of the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months. Conclusion: The nonunion rate of this novel cephalomedullary nail is comparable to what is reported in the literature. This nail is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.

scholarly journals Outcome of proximal femur shaft fractures in school going children treated with locking compression plates

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Faaiz Ali Shah ◽  
Mian Amjad Ali ◽  
Naeemullah .
Keyword(s):  
Clinical Outcome ◽  
Proximal Femur ◽  
Femoral Shaft ◽  
Radiological Outcome ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Locking Compression Plates ◽  
Clinical And Radiological Outcome ◽  
Femur Shaft ◽  
Femur Shaft Fractures

Objectives: To determine the clinical and radiological outcome of proximal femur shaft fractures in school going children treated with locking compression plates (LCP). Methods: This descriptive study was conducted in Orthopaedic Division Lady Ready Reading Hospital Peshawar from 25th June 2018 to 25th September 2020. Children of either gender and age 6 to 12 years old with subtrochanteric and proximal one third femur factures fulfilling the inclusion criteria were enrolled in this study. Open reduction and internal fixation with 4.5 mm narrow locking compression plates (LCP) were done in all. Post operative clinical outcome was evaluated by using Flynn scoring system and graded as excellent, satisfactory and poo results. Radiological assessment of fracture union was done through anteroposterior (AP) and lateral X-ray radiographs. Results: A total of 60 children with mean age 9.01±1.61 SD (range 6 to 12 years) were included in our study. Oblique fractures were present in 23(38.3%) children, spiral in 20(33.3%), transverse in 11(18.3%) and comminuted in 6 (10%) children. The radiological union time was 13.3±1.2 weeks (range 9.4 to 18 weeks). Majority (88.3%, n=53) of children had excellent clinical outcome according to Flynn’s scoring system while satisfactory outcome was noted in 7(11.6%) children. No cases of delayed union, mal union, nonunion and implant failure was reported. Conclusion: The results of our study indicated that proximal femoral shaft fractures in school going children treated with locking compression plates had excellent clinical and radiological outcome. We therefore recommend locking compression plate as the implant of choice to fix proximal femoral shaft fractures in school going children. doi: https://doi.org/10.12669/pjms.37.5.3938 How to cite this:Shah FA, Ali MA, Naeemullah. Outcome of proximal femur shaft fractures in school going children treated with locking compression plates. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.3938 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Safety and efficacy of a novel cephalomedullary nail in femoral shaft fractures: a retrospective observational cohort in 33 patients

2020 ◽  
Author(s):  
Jorge Clint De Leon ◽  
Khang H Dang ◽  
Cooper Benjamin Tye ◽  
Connor Scott Breinholt ◽  
Ravi A. Karia
Keyword(s):  
Failure Rate ◽  
Fracture Fixation ◽  
Femoral Fracture ◽  
Femoral Shaft ◽  
Cephalomedullary Nail ◽  
Safety And Efficacy ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Observational Cohort ◽  
Femur Shaft

Abstract Background: There is limited data on the efficacy and failure rate ofspecific implants for femoral fracture fixation. A novel cephalomedullary nail that provides various options for proximal and distal fixation is available on the market. However, limited information is available on the safety and efficacy of the specific implant. The aim of this study is to evaluate the postoperative complication rates related to the use of the novel cephalomedullary nail for femoral fracture fixation.Methods: Patients over 18 years of age, with traumatic femur shaft fractures, treated with this novel cephalomedullary nail and available for a minimum of 3-month follow-up were included for analysis. Retrospective chart review for this retrospective observational cohort study was performed. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation. We hypothesize that the union and failure rate will be similar to that reported in the literature for femur shaft fractures.Results: Of the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months. Conclusion: The nonunion rate of this novel cephalomedullary nail is comparable to what is reported in the literature. This nail is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.

scholarly journals Isolated Femoral Shaft Fracture in Wakeboarding and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Henrik Constantin Bäcker ◽  
Seth Shoap ◽  
Gabor Vasarhelyi ◽  
Gergely Pánics
Keyword(s):  
Sports Medicine ◽  
Case Series ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
High Energy ◽  
Muscle Injuries ◽  
Concomitant Injuries ◽  
Ao Classification ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Introduction. Wakeboarding is an extreme sport that has shown increasing popularity in recent years, with an estimated 2.9 million participants in 2017. Due to this trend, injuries related to this sport are likely to become more common. Isolated femoral shaft are rare; however, they occur much more frequently in youth as a result of high velocity events, such as dashboard-related injuries. Few studies have addressed injuries related to wakeboarding, and of those that have, most have reported on muscle injuries, ligament ruptures, and sprains. Due to the dearth in literature, we want to present two cases of isolated noncontact femoral shaft fractures that resulted from wakeboarding. Case Presentation. Two 28-year-old, otherwise healthy, wakeboarders—patient A, male, and patient B, female—presented to our Department of Orthopaedics and Sports Medicine with isolated femoral shaft fractures. Both were admitted due to wakeboard-related noncontact injuries, where patient A fell while performing a sit-down start during cable wakeboarding and patient B after attempting a wake-jump. Both patients were being pulled by motorboats at roughly 40 km/h. After clinical examination and radiography, left spiral (AO classification: 32-A1.2) (patient A) and right-sided bending, wedge (AO classification 32-B2.2) (patient B) isolated femoral shaft fractures were diagnosed. No concomitant injuries were reported. For treatment, long reamed locked nails were applied, while the patients were under spinal anaesthesia. Physiotherapy was prescribed postoperatively. Patient A returned to wakeboarding 155 days after the surgery, and patient B returned after approximately half a year. Conclusion. This case series shows that even in noncontact sports such as wakeboarding, high-energy forces applied to the femur can cause isolated femoral shaft fractures. Despite multiple reports in various sports of stress fractures of the femur, there are few publications of direct trauma.

Civilian Ballistic Femoral Shaft Fractures Compared with Blunt Femur Shaft Fractures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
David A Patch ◽  
Eli B Levitt ◽  
Nicholas A Andrews ◽  
Alex R Heatherly ◽  
Henry V Bonner ◽  
...  
Keyword(s):  
Femoral Shaft ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Femur Shaft ◽  
Femur Shaft Fractures

scholarly journals Fracture Table vs. Lateral Positioning for Intramedullary Fixation of Femur Fractures (The FLiP Study): A protocol for a pilot randomized controlled trial

2019 ◽  
Author(s):  
Daniel Axelrod ◽  
Herman Johal ◽  
Kim Madden ◽  
Francesc Marcano ◽  
Carlos Prada
Keyword(s):  
Pilot Trial ◽  
Case Series ◽  
Femoral Shaft ◽  
Intramedullary Fixation ◽  
Femoral Shaft Fractures ◽  
Randomized Controlled ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Fracture Table ◽  
Lateral Positioning

Background: Femoral Shaft fractures are devastating and life threatening injuries. Femoral shaft fractures are most commonly treated with intramedullary fixation. Malrotation of the injured limb after fixation is a common and significant complication following femoral shaft fractures. During the operation, patients can be positioned either supine or in a lateral position. Additionally, patients can be placed on a standard radiolucent operating room table, or placed on a fracture table with traction statically applied to the operative limb throughout the case. Previous case series and cohort studies have shown equivalence between study groups, but choice between positioning options remains controversial. Methods: This represents a protocol for a randomized controlled pilot trial. We will be compared lateral positioning with use of manual traction to supine positioning with use of a fracture table. Primary outcomes will be in assessment for feasibility for a future full scale randomized trial, including evaluating patient recruitment, patient compliance with followup, contamination between treatment arms and others. Results: The primary outcome will be feasibility for a future trial. Secondary outcomes will include malrotation as measured through postoperative computed tomography scans and gait analysis at 6 months.

scholarly journals Fracture Table vs. Lateral Positioning for Intramedullary Fixation of Femur Fractures (The FLiP Study): A protocol for a pilot randomized controlled trial

2019 ◽  
Author(s):  
Daniel Axelrod ◽  
Herman Johal ◽  
Kim Madden ◽  
Francesc Marcano ◽  
Carlos Prada
Keyword(s):  
Pilot Trial ◽  
Case Series ◽  
Femoral Shaft ◽  
Intramedullary Fixation ◽  
Femoral Shaft Fractures ◽  
Randomized Controlled ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Fracture Table ◽  
Lateral Positioning

Background: Femoral Shaft fractures are devastating and life threatening injuries. Femoral shaft fractures are most commonly treated with intramedullary fixation. Malrotation of the injured limb after fixation is a common and significant complication following femoral shaft fractures. During the operation, patients can be positioned either supine or in a lateral position. Additionally, patients can be placed on a standard radiolucent operating room table, or placed on a fracture table with traction statically applied to the operative limb throughout the case. Previous case series and cohort studies have shown equivalence between study groups, but choice between positioning options remains controversial. Methods: This represents a protocol for a randomized controlled pilot trial. We will be compared lateral positioning with use of manual traction to supine positioning with use of a fracture table. Primary outcomes will be in assessment for feasibility for a future full scale randomized trial, including evaluating patient recruitment, patient compliance with followup, contamination between treatment arms and others. Results: The primary outcome will be feasibility for a future trial. Secondary outcomes will include malrotation as measured through postoperative computed tomography scans and gait analysis at 6 months.

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.

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