scholarly journals A STUDY ON FRACTURE OF FEMUR SHAFT TREATMENT WITH INTRAMEDULLARY INTERLOCKING NAILING

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Ashok Meena ◽  
D S Meena ◽  
Narendra Saini ◽  
Poonam Meena
Keyword(s):  
Traffic Accidents ◽  
Femoral Shaft Fracture ◽  
Road Traffic ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Delayed Union ◽  
Interlocking Nailing ◽  
Shaft Fractures ◽  
Femur Diaphysis ◽  
Femur Shaft

Background: Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. Closed reduction and intramedullary interlocking nailing is the surgical treatment of choice for the closed shaft fractures of femur. Present study conducted to study the principles of intramedullary interlocking nailing and to assess the outcome of the patient. Methods: The present study comprises of 30 cases of fracture shaft of the femur in adults about >20 years old. All the fractures, which were included in the study were traumatic in origin, most of them are due to road traffic accidents. Results: The delayed union rate in our series was 6.67%. There were no non-unions. Conclusions: It is concluded that closed intramedullary interlocking nailing method given good result in treatment of shaft fractures of femur. Keywords: Intramedullary nailing, Femur, Diaphysis fractures, Interlocking

scholarly journals A study on fracture of femur shaft treatment with intramedullary interlocking nailing

2018 ◽  
Vol 4 (4) ◽  
pp. 562
Author(s):  
Shivashankarappa A. ◽  
Prasad N. C. ◽  
Shaik Hussain Saheb
Keyword(s):  
Surgical Treatment ◽  
Intramedullary Nailing ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Medical College ◽  
Interlocking Nailing ◽  
Shaft Fractures ◽  
Closed Intramedullary Nailing ◽  
Femur Shaft

<p class="abstract"><strong>Background:</strong> Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. Closed reduction and intramedullary interlocking nailing is the surgical treatment of choice for the closed shaft fractures of femur. Present study conducted to study the principles of intramedullary interlocking nailing and to assess the outcome of the patient.</p><p class="abstract"><strong>Methods:</strong> The present study comprises of 28 cases of fracture shaft of the femur admitted in orthopaedics wards of JJM Medical College, Davangere. Total 28 cases considered for closed intramedullary nailing.<strong></strong></p><p class="abstract"><strong>Results:</strong> In 55% cases closed intramedullary nailing given excellent healing of fracture, in 25% cases healing was good, in 10% cases it was average and 5% cases poor healing was observed.</p><p class="abstract"><strong>Conclusions:</strong> It is concluded that closed intramedullary interlocking nailing method given good result in treatment of shaft fractures of femur.</p>

scholarly journals Ipsilateral Acetabular Fracture with Displaced Femoral Head and Femoral Shaft Fracture: A Complex Floating Hip Injury

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raja Bhaskara Rajasekaran ◽  
Dheenadhayalan Jayaramaraju ◽  
Dhanasekara Raja Palanisami ◽  
Ramesh Perumal ◽  
Rajasekaran Shanmuganathan
Keyword(s):  
Femoral Head ◽  
Acetabular Fracture ◽  
Femoral Shaft Fracture ◽  
Road Traffic ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Complex Case ◽  
Acetabular Reconstruction ◽  
Rare Presentation ◽  
Hip Injury

Floating hip injuries involving the acetabulum, femoral head, and the femoral shaft are a very rare presentation. A complex floating hip injury comprising of an ipsilateral acetabular fracture associated with a displaced femoral head fracture and a femoral shaft fracture following a high-velocity road traffic accident presented to us where all the fractures were addressed with internal fixation during the primary surgery. Postoperatively, the patient suffered a dislocation of the femoral head which eventually went on to avascular necrosis at 5 months from the initial presentation. Then, the patient underwent a total hip replacement with an acetabular reconstruction following which he went on to have a good functional outcome. Our experience in dealing with such a complex case shows that it is difficult to set a protocol for such injuries and they need to be addressed on a case-to-case basis depending on the complexity of the injury.

scholarly journals Comparative Study of Management of Closed Comminuted Femoral Shaft Fractures with Closed Interlocking Intramedullary Nail and Open Reduction and Dynamic Compression Bridge Plating

2004 ◽  
Vol 43 (155) ◽  
Author(s):  
Bikram Prasad Shrestha ◽  
P Kumar ◽  
GK Singh
Keyword(s):  
Dynamic Compression ◽  
Femoral Shaft ◽  
Delayed Union ◽  
Permanent Disability ◽  
Femoral Shaft Fractures ◽  
Advantages And Disadvantages ◽  
Interlocking Nailing ◽  
Shaft Fractures ◽  
Segmental Fracture ◽  
Bridge Plating

Fracture shaft of the femur are life-threatening injuries and can cause severe permanent disability. Nowadays die interlocking nailing is regarded as the operative technique of choice for fracture shaft of femur. However, the advantages and disadvantages have rarely been compared with plate osteosynthesis. This is prospective study to compare the two methods of treatments in terms of time to union, hospital slay (including readmission), wound infection, shortening of limb, delayed union, malunion, joint stiffness and implant failure. 54 patients, age (16 to 66) years, were treated by DCP (22), and interlocking nail (24). Eight patients were lost to follow up. The study was conducted in Services Hospital, Department of Orthopaedics and Ittefaq Hospital, Lahore, Pakistan from June 1996 to Dec 1997. Written consent was taken regarding the type of surgery to be performed. Open fractures of Gustilo Grade n or in, femoral shaft fractures associated with other fractures of the same femur, fractures in immature skeleton and segmental fracture were excluded. Winquist and Hansen classification was used to classify fracture comminution. Patients were alternately allocated. In the plating group, primary bone grafting was done in all cases. Time to union in nailing group was 16.43t2.48 weeks and in plating 19.88±3.46 weeks, p-value<0.05. Mean hospital stay in nailing group was 12.8±2.75 day and plating group 21.1±2.73 days, p>0.05. There were 2 deep infections in the plating group and none in nailing group. There was no shortening of limb in die plating group but 2 patients in the nailing group had shortening of 2 cms. Delayed union occurred in 2 patients in nailing group but 5 in plating group. One patient in the nailing group had external rotation of at least 10 degrees and none in plating group. Two patients in the nailing group had knee stiffness and 6 patients in me plating group. One patient in the nailing group had a broken interlocking screw 2 patients in the plating group had bent plates. Closed interlocking intramedullary nailing as a method of treating closed communited femoral shaft fracture is better than plating in terms of rate of postoperative complication including infection.Key Words: Comminuted fractures shaft of femur, static interlocking nailing and bridge plating.

scholarly journals Role of Open Cerclage Wires Used in Patients with Comminuted Fractures of Femoral Shaft Treated with Intramedullary Nails

2020 ◽  
Author(s):  
Tzu-Hao Wang ◽  
Hao-Chun Chuang ◽  
Fa-Chuan Kuan ◽  
Chih-Kai Hong ◽  
Ming-Long Yeh ◽  
...  
Keyword(s):  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Fracture Treatment ◽  
Union Rate ◽  
Intramedullary Nails ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Significant Difference ◽  
Cerclage Wiring

Abstract IntroductionThe role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesize that open cerclage wiring is applicable to patients with severe comminuted femoral shaft fractures without affecting bone healing.Patients and MethodsThis retrospective cohort study used data of consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into wire and no wire groups according to the surgical technique used and their union rate was recorded. The patients were then divided into union and nonunion groups and their perioperative data were analyzed.ResultsIn total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini–open wound without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures united smoothly, and no significant difference was observed in any perioperative data between union and nonunion groups.DiscussionAugmented open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or far displaced. Thus, open cerclage wiring can be used for fracture treatment, without decreasing the union rate.

Outcome of Titanium Elastic Nailing in the Surgical Management of Femoral-Shaft Fracture in Children

2020 ◽  
Vol 2 (2) ◽  
pp. 61-66
Author(s):  
Rajram Maharjan ◽  
Rishi Bisht ◽  
Dipesh Pariyar
Keyword(s):  
Femoral Shaft Fracture ◽  
Insertion Site ◽  
Operating Time ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Age Group ◽  
Femoral Shaft Fractures ◽  
Titanium Elastic Nailing ◽  
Shaft Fractures ◽  
Fractures In Children

Introduction: Femoral shaft fracture is one of the most common orthopedic injuries of the children. These fractures treated non-operatively by traction followed by hip spica require prolonged hospitalization causing undue physical and psychological stress for patient and patient family. Loss of reduction is also commonly seen with hip spica that leads to unacceptable complications like angular deformities and limb length discrepancies. Titanium Elastic Nailing (TEN) is becoming widely accepted treatment for femoral shaft fractures in children due to its simplicity and physeal protective stable load sharing construct that allows early mobilization. The purpose of this study was to see the outcome of operative treatment of femoral shaft fracture in children by TEN. Methods: A retrospective observational study was carried out in the Department of Orthopedics in National Academy of Medical Sciences, National Trauma Center from February 2017 to January 2019. Study was undertaken in 22 children between the age group of 5-14 years with femoral shaft fractures. Fixation with TEN was done for all fractures within nine days of injury. Patients were assessed radiologically as well as clinically until fractures healed. The results were evaluated using Flynn scoring criteria. Results: Radiological union was seen in all cases between 6–12 weeks after surgery. The mean operating time was 58 (48-115) minute and mean hospital stay after surgery was 9 (6-15) days. Results were excellent in 14 patients (63.63%), satisfactory in 6 patients (27.37%) & poor in 2 patients (9%). Six patients had skin irritation at nail insertion site which resolved after removal of nails. Functional range of motion in both hip and knee joints of affected limb was preserved in all cases after the removal of nails. Conclusion: TEN is an effective and safe treatment of femoral shaft fractures in children of 5-14 years of age group.  

Determine the Mean Duration of Union in Femoral Shaft Fracture in Children Treated with Elastic Intra-Medullary Nailing

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

scholarly journals Nailing femoral shaft fracture with postless distraction technique: a new technique enabled by shape-conforming pad

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alessandro Aprato ◽  
Davide Carlo Secco ◽  
Andrea D’Amelio ◽  
Elena Grosso ◽  
Alessandro Massè
Keyword(s):  
Pudendal Nerve ◽  
Femoral Shaft Fracture ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Harris Hip Score ◽  
Control Group ◽  
Complication Rates ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures

Abstract Background Femoral shaft fractures are usually treated with nailing using a traction table and a perineal post, but this may occasionally result in various groin-related complications, including pudendal nerve neurapraxia. Although most of them are transient, complication rates of up to 26% are reported. Recently, postless distraction technique has been described for elective hip arthroscopy. In this study we compared post and postless distraction technique in femoral shaft fracture nailing in terms of (1) quality of reduction, (2) outcome, and (3) complications. Methods We reviewed 50 patients treated with postless distraction nailing technique for femoral shaft fractures and compared them with our historical case series (95 patients). The following data were collected for all patients: age, gender, weight, height, diagnoses (fractures were classified according to the 2018 revision of AO classification), type and size of nail surgical timing, Trendelenburg angles during surgery, quality of reduction according to Baumgaertner and Thoresen classifications, Modified Harris Hip Scores at 6 months, and perineal complications. Results Median age was 53 years, and median weight was 70 kg (range 50–103 kg). We found no significant difference in terms of quality of reduction (72 versus 74% “excellent” reduction for subtrochanteric fractures, while 81 versus 79% “excellent” reduction for femoral shaft fractures) and functional outcomes (Modified Harris Hip Score 74 versus 79). One patient in the control group had a failure of the fixation, and one patient in the postless group had a deep infection. Two patients in the control group reported pudendal nerve neurapraxia for 4 months, while none reported complication linked to the postless technique. Conclusions Our results using the postless distraction technique show a sufficient distraction to allow reduction and internal fixation of the femoral fracture with a standard femoral nail. Level of evidence: IV

scholarly journals An Occult Ipsilateral Femoral Neck Fracture Associated With Mid-Shaft Femur Fracture

2020 ◽  
Vol 7 (4) ◽  
pp. 185-188
Author(s):  
Shahin Talebi ◽  
◽  
Shayan Amjadi ◽  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Intraoperative Imaging ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Delayed Union ◽  
Adverse Outcomes ◽  
Femoral Shaft Fractures ◽  
Shaft Fractures ◽  
Neck Fracture

Occult ipsilateral femoral neck fractures associated with femoral shaft fractures are frequently missed. They may lead to adverse outcomes, such as fracture displacement and delayed treatment followed by poor outcomes, including delayed union, malunion, nonunion, and osteonecrosis, which may lead to early arthroplasty. These adverse effects can be prevented by the awareness of this combined injury pattern, the adequate preoperative and intraoperative imaging of the femoral neck, and proper treatment. A 27-year-old man was admitted with a displaced fracture of the right femur. Fluoroscopic evaluation was performed after the intramedullary nailing of the shaft fracture. The evaluation revealed an ipsilateral displaced femoral neck fracture, which was fixed with two cannulated screw inserted anterior to the nail. Between 2% and 9% of all femoral shaft fractures are associated with ipsilateral femoral shaft fractures. This case report necessitates the increase of awareness for the presence of associated femoral shaft and neck fractures in patients undergoing antegrade femoral nailing. Also, we recommend appropriate preoperative, intraoperative, and postoperative imaging.

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