Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult

Shin, Yong Woon; Sung, Yerl Bo; Choi, Jeong Yoon; Kim, Minkyu

doi:10.12671/jkfs.2011.24.4.313

Cited by 2 publications

(5 citation statements)

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“…Anatomically, the femoral subtrochanteric area tends to be associated with poor bony union attributable to a lesser degree of vascularization as compared to surrounding regions. However, intramedullary nailing has been widely utilized as a standard treatment in this area because it results in a relatively small amount of bleeding due to the lack of desquamation of soft tissues, a low risk in infection and delayed recovery of the femoral quadriceps muscle, low occurrence rates of nonunion, malunion, and failure of internal fixations, and allows for the avoidance of bone grafting 1 , 4) .…”

Section: Discussionmentioning

confidence: 99%

“…The frequent ununited fractures and failures of internal fixation associated screw-plate device used for extramedullary fixation have led to an increased use of intramedullary nailing as an alternative. This technique is becoming a more common treatment option, as it has been associated with fewer complications, a low occurrence of ununited fractures, and better mechanical and biological outcomes 1 , 2 , 3 , 4) .…”

Section: Introductionmentioning

confidence: 99%

“…In treating fractures, it is critical to analyze factors that may impact bony union in order to evaluate prognoses and make therapeutic decisions for patients. Various risk factors for nonunion, including age, sex, history of smoking, classifications of fractures, anatomical locations of fractures, associated injuries, operation methods and techniques, and post-operative methods for rehabilitation have been identified 4 , 5 , 6 , 7) . Those factors that are subject to adjustment should be carefully reviewed when assessing aspects of patient fractures in order to select the proper operation methods and postoperative treatments.…”

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices

et al. 2014

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PurposeTo evaluate the factors affecting the bone union time and the occurrence of nonunion after intramedullary nailing of subtrochanteric femoral fractures in adults.Materials and MethodsWe retrospectively reviewed data from 31 patients (22 men and 9 women) who had undergone femoral intramedullary nailing at least 1 year post-operatively and analyzed the bone union time, nonunion rates, and factors that affected the bone union time according to the fracture classification (AO and Fielding classifications), comminution of the medial cortex, reduction method, and additional cerclage wiring.ResultsThe average union time was 26.4 weeks. There were no differences in the bone union time according to the fracture classification, reduction method, or additional cerclage wiring. Significant differences were found in the bone union time between the medial cortex comminution and non-comminution groups. A relatively strong positive correlation was detected between the degree of post-operative displacement and the bone union time. Nonunion occurred in three cases and there was no failure of implants.ConclusionThe bone union time was not affected by the reduction method nor additional cerclage wiring in intramedullary nailing of subtrochanteric femur fractures. Comminution of the medial cortex and the degree of the postoperative displacement of fractures contributed to the delayed time of union.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices

et al. 2014

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“…하지만 최근 연구에서 골수 내 금속정 고정술 후 4.1-12%의 비교적 높은 불유합 발생률이 보고되고 있으며 14,16,18) . 이에 대한 치료로 역동화, 골이식, 금속정 교체술, 금속판 변환술, 금속판 보강술 등이 사용되 고 있다.…”

Section: 서 론 성인 대퇴골 간부 골절의 치료로 골수 내 금속정 고정술 은 가장 이상적인 치료 방법으로 알려져 있으며unclassified

“…이 중 금속정 교체술은 확공 후 보다 큰 직경의 금속정으로 교체하는 방법으로 현재 가장 널리 시행되고 있으며 4,5,13,20) 이의 초기 결과는 매우 우수한 것으로 알려 져 왔으나, 최근 여러 연구에서 예상했던 것보다 열등한 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 69 73 45 56 43 28 73 71 56 35 37 59 44 41 72 53 37 결과가 보고되었다 11,21) . , 최근 보다 다양하고 복잡한 골절과 접하게 되고 골수 내 금속정의 사용 빈도가 증가하면서 불유합의 빈도가 4.1-12% 까지 보고되고 있다 14,16,18) . 이러한 골수 내 금속정 고정술 후 불유합의 위험인자로 Shin 등 …”

Section: 서 론 성인 대퇴골 간부 골절의 치료로 골수 내 금속정 고정술 은 가장 이상적인 치료 방법으로 알려져 있으며unclassified

Augmentative Locking Plate Fixation for the Treatment of Femoral Nonunion after Intramedullary Nailing

et al. 2013

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Purpose:To evaluate the efficacy of the augmentative locking compression plate fixation in the treatment of femoral shaft nonunion occurring after intramedullary nailing. Materials and Methods: Between July 2004 and September 2012, a total of 17 patients (twelve men, five women, average age 52.5 years) who had femoral nonunions after primary intramedullary nailing for femoral shaft fractures were reviewed. The mean period of nonunion after primary nailing was 18.5 months. Leaving the nail in situ, an augmentative locking plate was applied to the nonunion site with simultaneous autogenous bone grafting, except for five hypertrophic nonunions. We followed up all patients with plain radiograph and evaluated clinical status to determine bone union. Results: All patients demonstrated evidence of fracture union with an average follow-up time of 5.0 (range 2 to 9) months. The time of operation was an average of 115 (range 45 to 160) minutes, and mean blood loss was 345.9 (range 150 to 700) ml. Two patients noted discomfort at the distal portion of plate, and one noted discomfort of donor site, but functional limitation was not observed in all patients. Conclusion: Augmentative locking plate fixation for diaphyseal femoral nonunion after intramedullary nailing is a reasonable treatment option with increased stability.

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult

Cited by 2 publications

References 29 publications

Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices

Factors Affecting Time to Bony Union of Femoral Subtrochanteric Fractures Treated with Intramedullary Devices

Augmentative Locking Plate Fixation for the Treatment of Femoral Nonunion after Intramedullary Nailing

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