The use of one compared with two distal screws in the treatment of femoral shaft fractures with interlocking intramedullary nailing. A clinical and biomechanical analysis.

Hájek, Petr; Bicknell, H R; Bronson, William; Albright, James A.; Saha, Sananda

doi:10.2106/00004623-199304000-00007

Cited by 61 publications

(29 citation statements)

References 22 publications

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“…Our study was retrospective and involved a broad range of cases and surgeon grades. This rate is similar to that documented in studies concerning specific procedures [1,2].…”

Section: Discussionsupporting

confidence: 89%

The rate of instrument breakage during orthopaedic procedures

Price

Molloy

Solan

et al. 2002

International Orthopaedics

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The current study investigates instrument breakages during both emergency and elective orthopaedic surgery. Over a 2 year period a total of 7,775 procedures were performed. We found that 14 instruments were broken during 12 operative cases. Drill bits accounted for the largest proportion of breakages (11/14), and a specialist registrar was the lead surgeon in the majority (8/12) of cases. Only one case had a consultant as the lead surgeon. In seven cases the broken bit of the surgical instrument was left in the patient. Documentation of this peri-operative complication was deficient, and the patient was often not informed.Résumé Cette étude enquête sur les ruptures d'instrument pendant les opérations de chirurgie orthopédique urgentes ou programmées. Sur une période de deux années un total de 7775 interventions a été exécuté. Nous avons noté que 14 instruments ont été cassés pendant 12 opérations. Les éléments de la perceuse comptent la plus grande proportion de ruptures (11/14) et un chirurgien confirmé était le chef d'équipe dans la majorité (8/12) de cas. Dans 7 cas le morceau cassé de l'instrument a été laissé dans le malade. La documentation de cette complication opératoire était défectueuse et souvent le malade n'était pas informé.

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“…Our study was retrospective and involved a broad range of cases and surgeon grades. This rate is similar to that documented in studies concerning specific procedures [1,2].…”

Section: Discussionsupporting

confidence: 89%

The rate of instrument breakage during orthopaedic procedures

Price

Molloy

Solan

et al. 2002

International Orthopaedics

View full text Add to dashboard Cite

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“…We also did not observe any fracture at screw sites in our study. Hajek et al reported that only one distal screw could provide adequate distal fixation [4]. The locking of a second distal hole was adequately performed in every case in group II in our series.…”

Section: Discussionmentioning

confidence: 45%

Nail over nail technique for distal locking of femoral intramedullary nails

Rohilla

Singh

Magu

et al. 2008

International Orthopaedics (SICOT)

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The free hand technique remains the most popular method for distal locking; however, radiation exposure is a major concern. In an endeavour to overcome this concern, distal locking with the nail over nail technique is evaluated. Seventy patients with femoral diaphyseal fractures treated by intramedullary nailing were divided in two groups for distal locking: either using the free hand technique (group I) or with the nail over nail technique (group II). The average number of images taken to achieve nail insertion without locking, for distal locking, and for the complete procedure in group I was 25.8, 24.2, and 50.08, respectively, compared with 24.8, 4.1, and 28.9, respectively, in group II (statistically extremely significant decrease in radiation). The nail over nail technique appears to be a reliable solution for decreasing radiation exposure during closed femoral intramedullary nailing. However, over-reaming of 1.5 mm is the key to the success of the technique.

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“…In our study aimed at addressing exactly this issue, we found that there is no significant difference in the results of the time to bone union, restoration of displaced fracture fragments, and shoulder function between patients who receives different numbers of distal interlocking screws. In a study by Hajek et al, 18) they found that there is no difference in the resistance to twisting whether or not 1 or 2 distal interlocking screws were used in the intramedullary nailing of a femoral bone. But, because the femoral bone receives the burden of weight differently to the humeral bone this finding is not entirely applicable to humeral shaft fractures.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures

Yang¹,

Kim

Kang

et al. 2015

Clinics in Shoulder and Elbow

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Background: Our aim was to make a comparative analysis of radiological and clinical outcomes of using either one or two interlocking distal screws on a Polarus intramedullary nail for the internal fixation of humeral shaft fractures. Methods: From January 2008 to March 2014, we enrolled 26 patients with humeral shaft fractures who were operated on using intramedullary nails. The patients were divided into 2 groups according to how many interlocking distal screws were used to lock the Polarus nail: in group 1, a single interlocking distal screw was used in 12 patients; and in group 2, double interlocking distal screws, in 14 patients. We compared the degree of recovery of the displaced fracture fragments between the two groups. To compare the nonunion and shoulder function, we assessed each patient's modified American Shoulder and Elbow Surgerns (ASES) score. Results: We found that 10 of 12 fractures achieved union in group 1, and 13 of 14 fractures, in group 2. We did not find a meaningful difference in the time to bone union between the two groups. The percentage of recovery of displaced fracture fragments until union was 66.9% for group 1 and 59.41% for group 2. At the final follow-up, we found that the scores for shoulder joint modified ASES was 78.7 for group 1 and 80.7 for group 2. Conclusions: Our results show that if locked appropriately, even a single screw on a Polarus nail can provide satisfactory radiological union and improved clinical outcome after intramedullary nailing of humeral shaft fractures.

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The use of one compared with two distal screws in the treatment of femoral shaft fractures with interlocking intramedullary nailing. A clinical and biomechanical analysis.

Cited by 61 publications

References 22 publications

The rate of instrument breakage during orthopaedic procedures

The rate of instrument breakage during orthopaedic procedures

Nail over nail technique for distal locking of femoral intramedullary nails

Comparing the Use of Single and Double Interlocking Distal Screws on a Polarus Intramedullary Nail for Humeral Shaft Fractures

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