Interlocked nailing for treatment of segmental fractures of the femur.

Wiss, Donald A.; Brien, W W; Stetson, William B.

doi:10.2106/00004623-199072050-00012

Cited by 120 publications

(75 citation statements)

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“…The average time of hospital stay in our study was an average of 10-15 days, compared to Wiss et al 9 12 days.…”

Section: Discussioncontrasting

confidence: 61%

A Prospective Study of Surgical Management of Fracture Shaft Femur With Closed Intramedullary Interlocking Nail.

D¹,

B.M²

2013

jemds

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HOW TO CITE THIS ARTICLE:Mahendranath Reddy D, Muralidhar BM. "A prospective study of surgical management of fracture shaft femur with closed intramedullary interlocking nail". Journal of Evolution of Medical and Dental Sciences 2013; Vol. 2, Issue 47, November 25; Page: 9098-9105. ABSTRACT: Orthopaedic surgeons often encounter diaphyseal femur fractures, because these fracture most often result from high-energy trauma, one must have high index of suspicion for complications. Currently surgery is indicated for most femur fractures because of high rate of union, low rate of complications and advantage of early stabilization which decreases the morbidity and mortality rate in patients. While the main stay of the treatment has been reamed interlocking intramedullary nailing. The present study is hospital based prospective study of 40 adult patients admitted in SSMC Hospital, TUMKUR between October 2010 -March 2012 and cases were followed regularly. The common age group involved was from 18-65 yrs. with mean age of 33.5, 36 patients were males, 4 were females. 16 fractures were on right side, 24 were on left side. Two (5%) fractures was in proximal third, 26 (65%) were in the middle third and 12 (30%) were in the lower third. Surgery was done at an average 3 days ranging from 2 -5 days. Duration of hospital stay was 12 days ranging from 10-15 days. Mean time for union was 20 weeks. There was one case of distal bolt backing out and there were three cases of superficial infection. Excellent to good result were seen in 75% of cases. INTRODUCTION:Orthopaedic surgeons often encounter diaphyseal femur fractures because these fractures most often result from high energy trauma, one must have a high index of suspicion for complications or other injuries. Advance in mechanization and acceleration of travel have been accompanied by increase in the number and severity of the fracture. Fracture femur results from the drawbacks of fast life and violence and are major source of mortality and morbidity in patients with such injury. The art of femoral fracture care is a constant balancing of the often-conflicting goals of anatomical alignment and early functional rehabilitation of limb.Closed nailing causes no damage to extra periosteal soft tissues and the biological environment round the fracture is least disturbed. Another important feature of the closed intramedullary interlocking nail is the chance for early ambulation of the patient which reduces the complications of prolonged bed ridden patient.Comminuted and segmental fractures of femoral diaphysis are often difficult to treat. When intermediate fragment is split or there is comminution of either level of segmental fracture, the interlocking nail is the only best available implant, since the conventional IM nailing does not provide adequate fixation.Proximal & Distal shaft fractures where one cannot get three point fixations can also be stabilized by use of interlocking nails. Intramedullary nail being close to centre of femur can tolerate bending and torsional loads be...

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“…The average time of hospital stay in our study was an average of 10-15 days, compared to Wiss et al 9 12 days.…”

Section: Discussioncontrasting

confidence: 61%

A Prospective Study of Surgical Management of Fracture Shaft Femur With Closed Intramedullary Interlocking Nail.

D¹,

B.M²

2013

jemds

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“…Clinically, the mechanical environment can be altered through increasing the amount of interfragmentary movement (IFM) by reducing the fixation stiffness of interlocked nails [2,4,[38][39][40][41][42] or external fixators [12,17,28]. The IFM is also influenced by the load on the operated leg due to gravity and muscle forces [7,14,20,36,43].…”

Section: Introductionmentioning

confidence: 99%

Temporal Variation in Fixation Stiffness Affects Healing by Differential Cartilage Formation in a Rat Osteotomy Model

Willie

Blakytny

Glöckelmann

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Dynamization involves a reduction in fixation construct stiffness during bone healing, allowing increased interfragmentary movement of the fracture through physiologic weightbearing and muscle contraction. Within some optimal range, interfragmentary movement stimulates healing, but this range likely varies across stages of bone healing. Questions/purposes How does the time of dynamization affect the cartilage formation, bony bridging, and bone resorption in a rat fracture-healing model? Methods Unilateral external fixators, stabilizing a 1-mm gap, were dynamized at 1 (D1 group, n = 10), 3 (D3 group, n = 11), or 4 (D4 group, n = 11) weeks postoperatively. Continuously 5 weeks stiff (S group, n = 10) and flexible (F group, n = 11) fixation were included for comparison. After 5 weeks, healing was evaluated by histomorphometric methods.

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“…Currently, there are several options in the treatment of femoral non-union after intramedullary nailing: reamed exchange nailing [5,6,13], dynamization [16], nail removal followed by plating [2], stable fixation with or without bone grafting [3,11,12], and external fixation [9]. Reamed exchange nailing results in few complications, does not require bone grafting, and offers the benefit of early rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

Kim

2005

International Orthopaedics (SICOT)

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We reviewed 15 patients with femoral nonunion after interlocking intramedullary nailing treated with plate augmentation and bone grafting with the nail in situ. The mean time from primary nailing to plate augmentation and bone grafting was 10 months. At the time of presentation, the patients had undergone an average of 1.6 operations from the time of their original injury. To achieve stability of the fracture, we applied an AO plate on the lateral aspect of the femur. The retained nail maintained alignment of the fracture, and plating did not require an extensive surgical approach. In all patients, there was visible motion at the fracture site; however, the motion disappeared after plate augmentation. All patients achieved radiological solid union at an average of 7.2 months.

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Interlocked nailing for treatment of segmental fractures of the femur.

Cited by 120 publications

References 0 publications

A Prospective Study of Surgical Management of Fracture Shaft Femur With Closed Intramedullary Interlocking Nail.

A Prospective Study of Surgical Management of Fracture Shaft Femur With Closed Intramedullary Interlocking Nail.

Temporal Variation in Fixation Stiffness Affects Healing by Differential Cartilage Formation in a Rat Osteotomy Model

Plate augmentation leaving the nail in situ and bone grafting for non-union of femoral shaft fractures

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