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

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.

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

Advances in Orthopedics ◽

10.1155/2020/7583204 ◽

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.

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A Clinical Comparison between Conservative Treatment and Intramedullary Nailing after Closed Reduction in the Treatment of Femoral Shaft Fractures of Children

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.1991.26.3.797 ◽

1991 ◽

Vol 26 (3) ◽

pp. 797

Author(s):

Chang Uk Choi ◽

Soo Kyoon Rah ◽

Jae Uk Kwon ◽

Jun Min Song ◽

Man Sik Yang ◽

...

Keyword(s):

Conservative Treatment ◽

Intramedullary Nailing ◽

Closed Reduction ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Clinical Comparison

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Open versus Closed Intramedullary Nailing of Femoral Shaft Fractures

Journal of Trauma and Acute Care Surgery ◽

10.1097/00005373-198610000-00011 ◽

1986 ◽

Vol 26 (10) ◽

pp. 923-926 ◽

Cited By ~ 9

Author(s):

R K LEIGHTON ◽

J P WADDELL ◽

J F KELLAM ◽

K G ORRELL

Keyword(s):

Intramedullary Nailing ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Open Versus ◽

Closed Intramedullary Nailing

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Percutaneous Skeletal Joysticks for Closed Reduction of Femoral Shaft Fractures During Intramedullary Nailing

Journal of Orthopaedic Trauma ◽

10.1097/00005131-200111000-00007 ◽

2001 ◽

Vol 15 (8) ◽

pp. 570-571 ◽

Cited By ~ 26

Author(s):

Gregory M. Georgiadis ◽

Alexandra M. Burgar

Keyword(s):

Intramedullary Nailing ◽

Closed Reduction ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Shaft Fractures

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

10.21203/rs.3.rs-26674/v1 ◽

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.

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