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 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 ◽  
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 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 Correction to: Safety and efficacy of a novel cephalomedullary nail in femoral shaft fractures: a retrospective observational cohort in 33 patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jorge C. De Leon ◽  
Cooper B. Tye ◽  
Connor S. Breinholt ◽  
Khang H. Dang ◽  
Ravi A. Karia
Keyword(s):  
Femoral Shaft ◽  
Cephalomedullary Nail ◽  
Safety And Efficacy ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Observational Cohort

An amendment to this paper has been published and can be accessed via the original article.

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.

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 Breakage of intramedullary femoral nailing or femoral plating: how to prevent implant failure

2022 ◽  
Vol 27 (1) ◽  
Author(s):  
Henrik C. Bäcker ◽  
Mark Heyland ◽  
Chia H. Wu ◽  
Carsten Perka ◽  
Ulrich Stöckle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Plate Osteosynthesis ◽  
Femoral Shaft ◽  
Intramedullary Fixation ◽  
Implant Failure ◽  
Average Risk ◽  
Rigid Fixation ◽  
Femoral Shaft Fractures ◽  
Non Union ◽  
Shaft Fractures

Abstract Introduction Intramedullary (IM) fixation is the dominant treatment for pertrochanteric and femoral shaft fractures. In comparison to plate osteosynthesis (PO), IM fixation offers greater biomechanical stability and reduced non-union rates. Due to the minimally invasive nature, IM fixations are less prone to approach-associated complications, such as soft-tissue damage, bleeding or postoperative infection, but they are more prone to fat embolism. A rare but serious complication, however, is implant failure. Thus, the aim of this study was to identify possible risk factors for intramedullary fixation (IMF) and plate osteosynthesis (PO) failure. Materials and methods We searched our trauma surgery database for implant failure, intramedullary and plate osteosynthesis, after proximal—pertrochanteric, subtrochanteric—or femoral shaft fractures between 2011 and 2019. Implant failures in both the IMF and PO groups were included. Demographic data, fracture type, quality of reduction, duration between initial implantation and nail or plate failure, the use of cerclages, intraoperative microbiological samples, sonication, and, if available, histology were collected. Results A total of 24 femoral implant failures were identified: 11 IMFs and 13 POs. The average age of patients in the IM group was 68.2 ± 13.5 years and in the PO group was 65.6 ± 15.0 years, with men being affected in 63.6% and 39.5% of cases, respectively. A proximal femoral nail (PFN) anti-rotation was used in 7 patients, a PFN in one and a gamma nail in two patients. A total of 6 patients required cerclage wires for additional stability. A combined plate and intramedullary fixation was chosen in one patient. Initially, all intramedullary nails were statically locked. Failures were observed 34.1 weeks after the initial surgery on average. Risk factors for implant failure included the application of cerclage wires at the level of the fracture (n = 5, 21%), infection (n = 2, 8%), and the use of an additional sliding screw alongside the femoral neck screw (n = 3, 13%). In all patients, non-union was diagnosed radiographically and clinically after 6 months (n = 24, 100%). In the event of PO failure, the placement of screws within all screw holes, and interprosthetic fixation were recognised as the major causes of failure. Conclusion Intramedullary or plate osteosynthesis remain safe and reliable procedures in the treatment of proximal femoral fractures (pertrochanteric, subtrochanteric and femoral shaft fractures). Nevertheless, the surgeon needs to be aware of several implant-related limitations causing implant breakage. These may include the application of tension band wiring which can lead to a too rigid fixation, or placement of cerclage wires at the fracture site.

A COMPARATIVE STUDY TO DETERMINE THE KNEE JOINT FUNCTIONAL OUTCOME IN PATIENTS WITH FEMUR SHAFT FRACTURES MANAGED OPERATIVELY OR CONSEVATELY AT NDOLA HOSPITAL:complete enumeration (Preprint)

2019 ◽  
Author(s):  
Ripedah Nakana
Keyword(s):  
Knee Joint ◽  
Functional Outcome ◽  
Road Traffic ◽  
Femur Fracture ◽  
Conservative Group ◽  
Femur Fractures ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Femur Shaft ◽  
Femur Shaft Fractures

BACKGROUND According to WHO, It has been reported that there has been a rise in road traffic accidents globally due to many factors. Consequently this has contributed to an increase in fracture of the femur in hospitals. The annual incidence of these Fractures has been estimated to be 10 per 100,000 persons and this incidence has been noticed to be higher among the youths decreasing after the age of 40 and then increasing in the elderly. These fractures are either managed conservatively or operatively. OBJECTIVE the aim of this study was to determine if there is a significant difference in knee joint functional outcome in patients with femur shaft fractures managed operatively and conservatively at Ndola Teaching Hospital at the orthopedics clinic and physiotherapy. This in future might help to place emphasis on government to sensitize the right measures needed to improve on the functional outcome of a knee joint in patients with femur fracture who are treated operatively or conservatively METHODS the method used for the study was a complete enumeration of all patients with femur fractures that were admitted at orthopedic ward, visited the orthopedic clinic and physiotherapy sessions at NTH between the period of July 2019 to September 2019. Data collected will be analyzed using a statistical data software called Statistical Package of Social Sciences (SPSS). The independent variable that will be considered in the study are age, DOI, DOA, femur shaft fractures, treatment and others that that will meet the selection Criteria. The dependent variable will be “Knee Joint Functional Outcome”. RESULTS Results did not show statistically significant difference in knee functional outcome for two methods (conservative or operative). In the current study it was noted that there was much reduction in swelling in the operative in comparison to the conservative group. We may therefore conclude that the operative management promises a better outcome especially when done on time. However it seemed the operative procedure was not preferred for any conservative approach however the study has shown an in depth feasibility study to affirm such findings in order to inform on policy or management paradigim shift. CONCLUSIONS There is need for further intervention in the management of femur fracture which complicates to poor knee joint function

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