A comparative study of fracture shaft of femur in adults treated with broad  dynamic compression plate versus intramedullary interlocking nail

Thapa, Shrawan Kumar; Dhakal, Shankar; Marasini, Rudra Prasad; Hamal, Bhadra; Kumar, Rem; Shrestha, Ruchi; Kandel, Manoj

doi:10.3126/jcmsn.v12i2.15453

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Internal fixator breakage occurs in approximately 3.5% to 13.3% of patients during internal fixation surgery follow-up [ 1 , 2 ]. These complications are a challenge for even the most experienced surgeons, and can cause the patient substantial functional impairments, such as persistent and prolonged physical and psychological disabilities.…”

Section: Introductionmentioning

confidence: 99%

Are there too many screw holes in plates for fracture fixation?

Chang

Yuwen

et al. 2017

BMC Surg

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BackgroundImplant breakage after the fixation of traumatic fractures is rare; however, when it occurs, it is debilitating for the patients and a challenge for surgeons. The purpose of this study was to analyze and identify the independent risk factors for implant breakage of traumatic fractures treated with plate osteosynthesis.MethodsWe reviewed the medical records of patients with a fracture to any part of their four extremities, clavicle, hand or foot, who underwent surgical plate osteosynthesis from January 2005 to January 2015, and who sustained a subsequent implant breakage. Kaplan–Meier univariate and multivariate Cox regressions were performed to identify independent associations of potential risk factors for implant breakage in this cohort.ResultsWe identified 168 patients who underwent plate osteosynthesis surgery and had subsequent internal fixator breakage. The mean patient age was 40.63 ± 16.71 years (range, 3 to 78 years), with 72.0% (121) males and 28.0% (47) females. The average time between surgery and implant breakage was 12.85 ± 12.42 months (range, 1 to 60 months). In the final regression model, we show that inserting screws close to the fracture line is an independent predictive risk factor for implant breakage (HR, 2.165, 95%CI, 1.227 to 3.822; P = 0.008).ConclusionsWe found that inserting screws close to the fracture line is related to an increased risk of internal fixator breakage in patients treated with plate osteosynthesis after fracture. Plates with additional holes likely lead to an increased risk of implant breakage, presumably because surgeons cannot resist inserting extra screws into the holes adjacent to the fracture line, which reduces the stiffness of the plate. We have addressed this problem by designing a plate without holes adjacent to the fracture line.

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Section: Introductionmentioning

confidence: 99%

Are there too many screw holes in plates for fracture fixation?

Chang

Yuwen

et al. 2017

BMC Surg

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“…Early rehabilitation of the injured limb and early return to the maximum level of previous function is the most important benefit of surgical treatment. There are two different ways to fix these fractures surgically : plating or intramedullary nailing [1][2][3][4][5][6][7]. Despite plate, intramedullary nail is an internal splint that helps femur in weight bearing.…”

Section: Introductionmentioning

confidence: 99%

Comparison Between Plating and Intramedullary Nailing in Treatment of open Femoral Shaft Fracture from 2014 to 2017

2023

J Orthop Res Ther

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Introduction:Open fractures, often occur following high-energy trauma, are considered as medical emergencies. Due to the role of femur in body weight bearing, fractures of this bone can lead to long-term morbidities ; Therefore, proper treatment is very important. Since there are less complications in intramedullary nailing, it is accepted as the gold standard of treatment in close femoral shaft fractures but there is no consensus about open fractures. The goal of this study was to compare the therapeutic results between intramedullary nailing and plating in the treatment of open femoral shaft fracture.Methods: This retrospective study was performed on 46 patients with isolated open femoral shaft fracture, who referred to Imam Khomeini Hospital in Ahvaz. patients were divided into two groups based on the method of treatment: plating / intramedullary nailing and their treatment results were compared. Results:The mean time of visible bony callus formation on X-ray was 6.82 ± 0.93 weeks in intramedullary nailing group and 7.84 ± 1.82 weeks in plating group. The infection rate was 14.3% in intramedullary nailing group and 4% in plating group. There were 4 cases of non-union in intramedullary nailing group and 2 cases in plating group, but no cases of mal-union were observed.Conclusions: There was no difference between two methods in rate of union and infection but residual pain is more significant in nailing group.

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“…In the follow-ups performed after fixation with the plate, the plate was broken at a rate of approximately 3.5% -13.3% [9,10]. It has been stated that most of the causes of failure of internal fixation materials are related to material fatigue [11].…”

Section: Introductionmentioning

confidence: 99%