The Efficacy of Single-stage Open Intramedullary Nailing of Neglected Femur Fractures

Boopalan, P.R.J.V.C.; Sait, Azad; Jepegnanam, Thilak Samuel; Matthai, Thomas; Varghese, Viju Daniel

doi:10.1007/s11999-013-3293-z

Cited by 12 publications

(8 citation statements)

References 12 publications

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“…At 61 days, traction length of hospital stay reported in this study is similar to other studies conducted in LMICs (52-66 days) [12,[17][18][19]. However, the duration of hospital stay for IM nailing (36 days) was longer than previous reports [28][29][30] primarily due to a nearly 3 weeks delay from admission to surgery. These long delays were related to the limited availability of implants, surgical personnel and operating room space.…”

Section: Discussionsupporting

confidence: 83%

The Cost of Intramedullary Nailing Versus Skeletal Traction for Treatment of Femoral Shaft Fractures in Malawi: A Prospective Economic Analysis

et al. 2018

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Section: Discussionsupporting

confidence: 83%

The Cost of Intramedullary Nailing Versus Skeletal Traction for Treatment of Femoral Shaft Fractures in Malawi: A Prospective Economic Analysis

et al. 2018

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“…The results of our study are quite comparable to other studies done about this procedure. 8,15 The study by Boopalan et al was conducted on 17 patients while our study was conducted on 20 patients, the average time to union was 16 weeks while in our study it was 22.6 weeks which is favourably comparable. 8 The study by Akinyoola et al was conducted on 52 patients and average time to union was 20 weeks, though the sample size of this study was much larger than our 20 patients, but its results compare quite favourably to our study.…”

Section: Discussionsupporting

confidence: 54%

“…Several studies have demonstrated the effectiveness of open intramedullary nailing of femur, especially in neglected cases. [6][7][8] In the present study we evaluated the effectiveness of single stage open interlocking intramedullary nailing in neglected fracture shaft of femur patients through the assessment of attainment of union of the fracture and functional results of the limb.…”

Section: Introductionmentioning

confidence: 99%

A study on management of neglected shaft femur fractures by open intramedullary nailing

Jan¹,

Jahan²,

Dar³

et al. 2018

Int J Res Orthop

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Background: Fracture shaft of femur is a common and major musculoskeletal injury and in most of the cases the patients are immediately brought to hospitals for specialist orthopaedic management. However, it is not uncommon in developing countries especially in rural India for these injuries to be neglected initially due to the wide spred practice of quackery. The purpose of this study was to evaluate the effectiveness of open intramedullary nailing in the management of neglected fracture shaft femur patients in relation to achievement of union and functional results.Methods: This was a prospective observational study conducted on 20 patients presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, Nuh, Haryana between August 2013 and December 2016, with a diagnosis of neglected fracture shaft of femur. All the patients underwent single stage open reduction and internal fixation with interlocking intramedullary nails. The patients were followed up for a period of 1 year. The patients were analysed for union and functional results.Results: All the fractures united and the average time of union was 22.6 weeks. The average range of motion of the knees improved from 34 degrees in the preoperative period to 114.5 degrees in the postoperative period. Two patients developed superficial infections at the incision site which resolved with local drainage and oral antibiotics. All the patients were able to return to their preinjury occupation.Conclusions: Thus results of our study demonstrate that single stage open intramedullary nailing is a safe and effective surgical procedure for the treatment of neglected fractures of shaft of femur.

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“…In another study, a secondstage open tissue release and fracture reduction were adopted for intramedullary nailing after preoperative skeletal traction, but bone grafting was needed, which increased surgery complication and medical cost greatly 5 . A recent study reported that a single-stage open nailing technique using judicious bone resection and manual traction could be applied intraoperatively without preoperative skeletal traction 10 . However, this open reduction and fixation resulted in more tissue injury and blood loss with higher potential infection risk 5,10 .…”

Section: Introductionmentioning

confidence: 99%

“…A recent study reported that a single-stage open nailing technique using judicious bone resection and manual traction could be applied intraoperatively without preoperative skeletal traction 10 . However, this open reduction and fixation resulted in more tissue injury and blood loss with higher potential infection risk 5,10 . Actually, the main obstacle for closed intramedullary nailing is the laborious reduction of the fracture intraoperatively because of the limited strength of the local distractor or traction table 7,11,12 .…”

Section: Introductionmentioning

confidence: 99%

One‐Stage Closed Intramedullary Nailing for Delayed Femoral Fracture in Multiple Injured Patients

Yan

et al. 2022

Orthopaedic Surgery

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Objective: To tackle the challengeable dilemma of delayed femoral fracture, a technique of fixator-assisted closed reduction and intramedullary nailing at one stage was introduced herein and its clinical results were investigated.Methods: A retrospective study was conducted on delayed femoral shaft fracture between February 2008 and January 2017. The multiple injured patients aged from 18 to 60 years with delayed femoral fracture was included. All patients were treated by one-stage internal fixation technique and followed up for more than 1 year. Outcome measures including the operation time, intraoperative blood loss and limb alignment, healing time of fracture, visual analog scale (VAS), and range of knee motion were recorded and evaluated.Results: A total of 13 patients (16 sides) with a mean injury severity score (ISS) of 32.77 AE 9.98 (range, 19 to 52) participated in the investigation. The median length of time-after-fracture was 38 days (range, 21 to 110 days). The average shortening distance of the fracture ends was 35.48 AE 19.24 mm (range, 10.00 to 79.00 mm). The average surgery time was 192.19 AE 29.38 min for unilateral femoral fracture, with blood loss of 587.50 AE 232.02 ml. The postoperative discrepancy of lower limb was 3.87 AE 2.52 mm. No patient had vascular and neurologic complications due to the lengthening. All fractures healed successfully with a mean time of 2.98 AE 0.57 months. The mean VAS and maximal knee flexion were 1.63 AE 1.09 and 131.25 AE 5.32 at final follow-up, respectively. Conclusions: Our findings indicated that fixator-assisted closed reduction and intramedullary nailing at one stage is an effective treatment for delayed femoral fracture with satisfactory functional recovery.

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The Efficacy of Single-stage Open Intramedullary Nailing of Neglected Femur Fractures

Cited by 12 publications

References 12 publications

The Cost of Intramedullary Nailing Versus Skeletal Traction for Treatment of Femoral Shaft Fractures in Malawi: A Prospective Economic Analysis

The Cost of Intramedullary Nailing Versus Skeletal Traction for Treatment of Femoral Shaft Fractures in Malawi: A Prospective Economic Analysis

A study on management of neglected shaft femur fractures by open intramedullary nailing

One‐Stage Closed Intramedullary Nailing for Delayed Femoral Fracture in Multiple Injured Patients

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