Trochanteric Nail Insertion for the Treatment of Femoral Shaft Fractures

Ricci, William M.; Devinney, Scott; Haidukewych, George; Herscovici, Dolfi; Sanders, Roy

doi:10.1097/01.bot.0000164594.04348.2b

Cited by 58 publications

(48 citation statements)

References 18 publications

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“…The infection rate of 6.5% is not uncommon in a peripheral hospital like ours. The infection rate for Orthopaedic surgery ranges from 1% to 12.5% (15,16). The superficial infections were managed by antibiotics and dressing with iodine.…”

Section: Discussionmentioning

confidence: 99%

Outcome of surgical implant generation network nail initiative in treatment of long bone shaft fractures in Kenya

Soren¹

2010

E Af Orth Jnl

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Section: Discussionmentioning

confidence: 99%

Outcome of surgical implant generation network nail initiative in treatment of long bone shaft fractures in Kenya

Soren¹

2010

E Af Orth Jnl

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“…Technical errors like prominence of nail or locking bolts causing early removal of implants were seen more commonly in patients operated at night. Delayed and non-union after IMN of the femur is reported to be less than 10%, [17,18] and in tibial fractures, the incidence was 8-16%. [19] In this study, the incidence of non-union in femur fractures was 5.69% and in tibia fractures was 8.47%, but the incidence was significantly higher in patients who underwent surgery as an emergency procedure at night as compared to a daytime surgery.…”

Section: Discussionmentioning

confidence: 99%

Are we prepared for "Out of Hours" Orthopaedic Trauma Surgery?: A Retrospective Analysis.

Al-saflan¹,

Azam²,

Sadat-Ali³

2012

Ulus Travma Acil Cerrahi Derg

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AMAÇBu geriye dönük çalışma, femur ve tibia kırığına bağlı intramedüller çivileme (İMÇ) işlemi geçiren hastalarda elektif prosedüre karşı acil girişim sonuçlarında bir değişiklik olup olmadığını belirlemek amacıyla yapıldı. GEREÇ VE YÖNTEMTüm veriler, 1 Ocak 2004 ile 30 Haziran 2009 tarihleri arasında İMÇ gerektiren femur ve tibia kırığı olan erkek hastaların kaldığı ortopedi yatakhanelerinden toplandı. Toplanan veri, acil veya elektif prosedür şeklinde gerçekleştirilen cerrahiyi, cerrahinin süresini, karşılaşılan komplikasyonları ve kırığın kaynama durumunu içerdi. BULGULARTibia, fibula ve femur 431 kırık vardı. Femur kırığı ile ilgili ameliyat süresi, acil bir prosedür şeklinde gerçekleş-tirilmesi durumunda elektif prosedür olarak gerçekleştiril-me durumuna göre anlamlı şekilde daha uzundu (191±79 ve 155±65 dk; p≤0.001, güven aralığı [GA] -19.54). Tibia kırığında ameliyat süresi 167.1±62 ve 69.2±35 dk bulundu (p<0.001, GA <-85.4). Enfeksiyon, ikincil cerrahi ve kaynama komplikasyonları, elektif cerrahiye göre acil prosedürlerde daha yaygındı. SONUÇCerrahi süresindeki artış nedeniyle acil cerrahide komplikasyonlar elektif cerrahiye göre daha yüksek bulunmuştur. Bu durum, acil prosedürler sırasında özel eğitimli ortopedik hasta bakım personeli ve ameliyathanenin bulunmamasına bağlanabilir. Hastanelerde acil kırık tespitleri ve tedavisi icin özel ortopedi travma alanları oluşturulması gerektiğine inanmaktayız.Anahtar Sözcükler: Acil bakım; elektif cerrahi; kırıklar; travma. BACKGROUNDThis retrospective analysis was done to determine whether there is a change in outcomes of trauma patients undergoing intramedullary nailing (IMN) for femur and tibia fracture as an emergency versus elective procedure. METHODSData were collected for all patients admitted to male orthopedic wards between 1 January 2004 and 30 June 2009 with femur and tibia fractures that required IMN. The data collected included surgery undertaken on as emergency or elective procedure, duration of surgery, complications encountered, and union status of fracture. RESULTSThere were 431 fractures of the tibia, fibula and femur. Operating time for femur fracture as an emergency procedure was significantly greater than for elective surgery (191±79 versus 155±65 minutes; p≤0.001,). For tibia fracture, operating times were 167.1±62 versus 69.2±35 minutes (p<0.001, CI <-85.4). Complications of infection, secondary surgery and of union were more common in emergency procedures than elective surgeries. CONCLUSIONThis study shows that complications are higher in emergency surgery than elective surgery due to the increase in the duration of surgery. This is attributed to the non-availability of dedicated trained orthopedic nursing staff and theater during emergency procedures. We believe that it is time to develop dedicated orthopedic trauma theaters in hospitals that treat emergency fracture fixations.

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“…10,11 Thirty seven of the 38 fractures from the GT group and 52 of the 53 fractures from the PF group healed after the index procedure. One patient from the GT group had external rotation malalignment of 12°.…”

Section: Mode Of Injurymentioning

confidence: 99%

A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture

2016

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Background: In case of close nailing for femoral shaft fractures, the nail is inserted into the medullary cavity through the proximal femur without disturbing the periosteal blood supply of at the fracture site. The piriformis fossa and greater trochanter has been commonly described as starting points for antegrade femoral nailing. The purpose of this study was to compare results of two entry ports being used for intramedullary nailing for femoral shaft fractures.Methods: This study was conducted during a period of one year. The patients admitted with femoral diaphyseal fractures for antegrade nailing were divided in two groups alternatively for piriformis fossa entry point and greater trochanter entry point. Total number of patient in each group was 25 (n = 25). Functional outcome were analyzed at final follow up using Hari’s hip score.Results: There was no significant difference clinical and functional output in both group but intraoperative time and fluoroscopic time was significant (P <0.001).Conclusions: Femoral nailing through the greater trochanter entry portal with specifically designed nails should be considered a rational alternative to femoral nailing compared to Piriformis fossa entry portal with the benefit of reduced requirement for fluoroscopy and decreased operative time in obese patients. Statistically no significant difference (>0.005) in clinical and Functional outcome based on Hari’s hip score.

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Trochanteric Nail Insertion for the Treatment of Femoral Shaft Fractures

Cited by 58 publications

References 18 publications

Outcome of surgical implant generation network nail initiative in treatment of long bone shaft fractures in Kenya

Outcome of surgical implant generation network nail initiative in treatment of long bone shaft fractures in Kenya

Are we prepared for "Out of Hours" Orthopaedic Trauma Surgery?: A Retrospective Analysis.

A prospective randomized comparative study between trochanteric versus piriformis entry portal for intramedullary interlock nailing in the treatment of femoral shaft fracture

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