Treatment of the femoral shaft nonunion with double plate fixation and bone grafting: A case series of 14 patients

Maimaitiyiming, Asihaerjiang; Amat, Abdusami; Aili, Rehei; Tusongjiang, Mamatkeremula; Cao, Li

doi:10.1016/j.injury.2015.01.009

Cited by 34 publications

(27 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, augmented fixation with additional medial plate is a standard procedure associated with high union rates and no significant postoperative complications . Double plating technique is recommended by many authors for cases where single plate use is not adequate .…”

Section: Discussionmentioning

confidence: 99%

Is augmented LISS plating biomechanically advantageous over conventional LISS plating in unstable osteoporotic distal femoral fractures?

Todorov

Zderic

Richards

et al. 2018

Journal Orthopaedic Research

View full text Add to dashboard Cite

Treatment of complex osteoporotic distal femur fractures with the Less Invasive Stabilization System (LISS) has been associated with high complication rates. The aim of this study was to investigate the biomechanical competence of two different techniques of augmented versus conventional LISS plating. Unstable distal femoral fracture AO/OTA 33-A3 was created via osteotomies in artificial femora simulating osteoporotic bone. Three study groups, consisting of 10 specimens each, were created for fixation with either LISS plate, LISS plate with additional polylactide intramedullary graft, or LISS plate plus medial locking plate (double plating). All specimens were non-destructively tested under axial (20-150 N) and torsional (0-4 Nm) quasi-static loading. Each bone-implant construct was tested with two different working length (WL) configurations (long and short) of the LISS plate. Relative movements between the most medial superior and inferior osteotomy aspects were investigated via three-dimensional motion tracking analysis. Double plating revealed significantly smaller longitudinal and shear displacement than the other two techniques (p ≤ 0.001). In addition, LISS plus graft fixation was with significantly less longitudinal displacement in comparison to conventional LISS plating (p < 0.001). Long WL resulted in significantly higher longitudinal and shear displacement compared to short WL for LISS and LISS plus graft (p ≤ 0.032), but not for double plating (p > 0.999). In conclusion, intramedullary grafting resulted in significantly increased fracture stability under axial loading in comparison to conventional LISS plating. Although it was not efficient enough to provide comparable stability to double plating, intramedullary grafting may be considered as a useful biological alternative to the latter in a surgeon's armamentarium. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2604-2611, 2018.

show abstract

Section: Discussionmentioning

confidence: 99%

Is augmented LISS plating biomechanically advantageous over conventional LISS plating in unstable osteoporotic distal femoral fractures?

Todorov

Zderic

Richards

et al. 2018

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…However, patient in this case was young, the proximal femur was retained intactly and structure of the tumor prosthesis was modular, so we considered to replace part of this prosthesis at affected femoral side and meanwhile repair the bone defect with allograft at fracture position according to preoperative design. [ 16 – 18 ] Postoperative x-ray showed that the counterpoint and alignment were good at affected lower limb at 22 months follow-ups. The patient even could squat in a satisfied angle with aid at only 1 month postoperative follow-up and could still perform this movement by herself at 27th month, which can be an evidence of the short-term effect of this revision method.…”

Section: Discussionmentioning

confidence: 99%

Individualized reconstruction for severe periprosthetic fractures around the tumor prosthesis of knee under assistance of 3D printing technology

et al. 2018

View full text Add to dashboard Cite

Introduction:Periprosthetic femoral fractures (PFF) around tumor prosthesis of knee are stubborn problems for surgeons, huge bone defect and inappropriate biomechanics of the revision implant design can be disaster for reconstruction. With the development of three-dimensional (3D) printing technology, surgeons participate more in precise preoperative design and simulation for treatment of such fractures. In this study we explored an accurate and feasible way to restore normal anatomy and function of the knee joint with 3D printing technology.Case presentation:Rationale: This report explored an accurate and feasible way to treat PFF around tumor knee prosthesis in a 32 years old women with 3D printing technology, which restored normal anatomy and function of the knee joint. Patient concerns: Pain in left thigh lasted for 10 months after resection of left femoral chondroma and knee joint replacement four years ago. Diagnoses: periprosthetic femoral fractures (PFF) around tumor knee prosthesis.Interventions:CT images of the patient were collected and reconstructed. Parameters of bilateral femurs were virtually sliced and measured. Novel femoral stem and nail paths were specially designed by doctors according to these parameters. The prosthetic femoral stem components and navigator were customized by engineers according to the doctor's design. The residual femoral resin model, customized components and navigator were printed with Stereo Lithography Apparatus 3D printer. The shape-preconcerted allograft bone was selected as patch for the bone defect before operation with the printed bone model. All the steps were simulated preoperatively with the models printed, and then the operation was carried out. Outcomes: The operation was successfully performed. The postoperative x-ray image, MSTS93 scores were examined and the function restoration sustained well in the follow-up period from 1 month to 27 months. Lessons: 3D printing and medical interaction are key points in complex PFF cases.Conclusion:As for PFF of the complex tumor of knee, preoperative design and simulation with 3D printing technology may provide more accurate and effective operative outcome than traditional methods, which might be considered as a method suitable for popularization in complex and severe cases.

show abstract

Section: Wstępunclassified

“…The prognosis and consequences of fractures are always serious and especially at older age treatment should be planned carefully due to a high risk of complications [8][9][10]. Because of the pain and the presence of many possible failure factors and complications as well as significant limitation of patient mobility, this type of injury also represents a serious social and economic problem [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Kon se kwen cje zła ma nia, jak i ro ko wa nie są za wsze po wa żne i szcze gól nie w star szym wie ku le cze nie, ze wzglę du na wy so kie ry zy ko kom pli ka cji, po win no być do kład nie pla no wa ne [8][9][10]. Te go ty pu uraz, ze wzglę -du na ból, mo żli we licz ne czyn ni ki nie po wo dze nia i kom pli ka cje oraz znacz ne ogra ni cze nie mo bil no ści pa cjen ta sta no wi rów nież po wa żny pro blem na tu ry społecz nej i eko no micz nej [11][12][13][14].W przy pad ku skom pli ko wa nych zła mań naj częst -szym ty pem po stę po wa nia jest le cze nie ope ra cyj ne z wy jąt kiem sy tu acji, w któ rych mo żli we ry zy ko prze wy ższa ewen tu al ne ko rzy ści. Jed ną z mo żli wych tech nik jest sto so wa nie gwoź dzi śród sz pi ko wych zarów no w le cze niu pier wot nym, jak i wtór nym (re opera cyj nym) [15].…”

unclassified

See 1 more Smart Citation

Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

Słowiński

Kudłacik²

2016

Ortop Traumatol Rehabil

View full text Add to dashboard Cite

Po wi kła nie zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi ko wym -nu me rycz na ana li za przy pad ku kli nicz ne go STRESZ CZE NIECe lem pra cy by ła nu me rycz na ana li za przy pad ku zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi kowym i po twier dze nie wa run ków, któ re do pro wa dzi ły do wy kształ ce nia sta wu rze ko me go w miej scu zła ma nia.Ni sko ener ge tycz ne zła ma nie ko ści udo wej sta bi li zo wa no za po mo cą śród sz pi ko we go gwoź dzia krę ta rzo we go ChFN Sys tem z pi nem de ro ta cyj nym. Z wy ko rzy sta niem me to dy ele men tów skoń czo nych opra co wa ny zo stał układ kość -im plant, któ ry umo żli wił ob ser wa cję po la prze miesz czeń oraz od kształ ceń w re jo nie szcze li ny zła ma nia. Ob licze nia prze pro wa dzo no na 3 wa rian tach mo de lu, z gwoź dziem ty ta no wym (10 mm i 12 mm) oraz sta lo wym (10 mm). Ana li za roz kła du od kształ ceń wska za ła, że naj więk sze ich war to ści lo ka li zu ją się w szcze li nie zła ma nia i są wy ższe w przy pad ku za sto so wa nia im plan tu ze sto pu ty ta nu (0-17% vs 0-11%). Ru chy mię dzy odła mo we po wo do wa ne przyło żo nym ob cią że niem by ły ta kże wy ższe w przy pad ku za sto so wa niu im plan tu ze sto pu ty ta nu. Ana li za od kształ ceń wska za ła, że od se tek ele men tów w ob sza rze szcze li ny, po ten cjal nie zdol nych do two rze nia tkan ki kost nej jest wyższy w przy pad ku za sto so wa nia im plan tu sta lo we go.Mo żli we jest wska za nie miejsc, w któ rych zaj dzie nie ko rzyst na od bu do wa szcze li ny zła ma nia, co mo że do prowa dzić do po wsta nia sta wu rze ko me go. Za sto so wa nie im plan tu sta lo we go pod no si praw do po do bień stwo uzy ska nia sta bil ne go zro stu kost ne go.Słowa kluczowe: MeSH, hip frac tu res, pseu dar th ro sis, com pu ter si mu la tion SUMMARYThe aim of this paper is to conduct a numerical analysis of a case of femoral fracture treated by intramedullary nailing and confirm the conditions which led to the formation of a pseudarthrosis at the fracture site.A low-energy femoral fracture was treated by placing a ChFN System intramedullary nail with a derotation pin. Using the finite element method, a bone-implant system was generated which made it possible to observe the dis placement area and strains in the region of the fracture gap. The calculations were conducted for 3 variants of the model, using a titanium nail (10 mm and 12 mm) and a steel one (10 mm). Analysis of strain distribution indicated that the highest strain values occur in the fracture gap and that they are higher when a titanium alloy is used (0-17% vs 0-11%). Interfragmentary movements caused by an imposed load were also higher when a titanium alloy implant was used. Strain analysis showed that the percentage of elements in the gap area which are potentially able to grow bone tissue is higher when a steel implant is used.It is possible to indicate sites where unfavourable fracture gap healing will take place, which may lead to the deve lopment of a pseud...

show abstract

Treatment of the femoral shaft nonunion with double plate fixation and bone grafting: A case series of 14 patients

Cited by 34 publications

References 46 publications

Is augmented LISS plating biomechanically advantageous over conventional LISS plating in unstable osteoporotic distal femoral fractures?

Is augmented LISS plating biomechanically advantageous over conventional LISS plating in unstable osteoporotic distal femoral fractures?

Individualized reconstruction for severe periprosthetic fractures around the tumor prosthesis of knee under assistance of 3D printing technology

Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

Contact Info

Product

Resources

About