DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175938

Femoral diaphysis fractures: treatment with unreamed intramedullary nailing and its results

Murat Demiroğlu

Abstract


Background: Femoral shaft fractures are an important cause of mortality and morbidity in the lower extremity injuries.

Methods: 21 femoral body fractures of 19 adult patients were treated with the unreamed intramedullary nailing. Of 19 patients 14 were males and 5 were females.

Results: All fractures healed. Deep infection was not encountered. According to the Thoresen criteria, the rate of excellent-good results was 78%. In two patients, who had also cranial trauma, development of excessive callus was observed. None of the patients required a secondary operation.

Conclusions: Unreamed intramedullary nailing, if it can be implemented with closed technique and with double lock screw at the distal side, provides satisfactory results in the femoral shaft fractures.

 


Keywords


Femur fractures, Unreamed intramedullary nailing, Closed technique

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References


Brown DE, Neumann RD. Orthopedic Secrets. 3rd Edition. Philadelphia: Hanley & Belfus; 2004: 301.

Browner B, Jupiter J, Levine A, Trafon P. Skeletal Trauma. Fourth Edition. Philadelphia: Saunders Elsevier; 2009;2:2035-72.

Brumback RJ, Ellison PS Jr, Poka A, Lakatos R, Bathon GH, Burgess AR. Intramedullary nailing of open fractures of the femoral shaft. J Bone Joint Surg Am. 1989;71(9):1324-31.

Canale ST. Campbell’s Operative Orthopaedics. Mosby. 1998;3:2136-63.

Wu CC, Shih CH, Ueng WN, Chen YJ. Treatment of segmental femoral shaft fractures. Clin Orthop Relat Res. 1993;287:224-30.

Kempf I, Grosse A, Beck G. Closed locked intramedullary nailing. Its application comminuted fractures of the femur. J Bone Joint Surg Am. 1985;67(5):709-20.

Winquist RA, Hansen ST Jr, Clawson DK. Closed intramedullary nailing of femoral fractures. A report of fıve hundred and twenty cases. J Bone Joint Surg Am. 1984;66(4):529-39.

Brumback RJ, Ellison TS, Poka A, Bathon GH, Burgess AR. Intramedullary nailing of femoral shaft fractures. Part III: Long-term effects of static interlocking fixation. J Bone Joint Surg Am. 1992;74(1):106-12.

Thoresen BO, Alho A, Ekeland A, Stromsoe K, Folleras G, Haukebo A. Interlocking intramedullary nailing in femoral shaft fractures. A report of forty-eight cases. J Bone Joint Surg Am. 1985;67(9):1313-20.

Wiss DA, Brien WW, Stetson WB. Interlocked nailing for treatment of segmental fractures of the femur. J Bone Joint Surg Am. 1990;72(5):724-8.

Brumback RJ, Ellison PS Jr, Poka A, Lakatos R, Bathon GH, Burgess AR. Intramedullary nailing of open fractures of the femoral shaft. J Bone Joint S Am. 1989;71(9):1324-31.

Rockwood CA, Bucholz RW, Heckman JD, Court-Brown CM. Rockwood and Green's Fractures in Adults. Chapter 27. Lippincott Williams Wilkins; 2006: 1827-1918.

White GM, Healy WL, Brumback RJ, Burgess AR, Brooker AF. The treatment of fractures of the femoral shaft with the Brooker- Wills distal locking intramedullary nail. J Bone Joint Surg Am. 1986;68(6):865-76.

Lhowe DW, Hansen ST. Immediate nailing of open fractures of the femoral shaft. J Bone Joint Surg Am. 1988;70(6):812-20.

Søjbjerg JO, Eiskjaer S, Møller-Larsen F. Locked nailing of comminuted and unstable fractures of the femur. J Bone Joint Surg Br. 1990;72(1):23-5.

Loch DA, Kyle RF, Bechtold JE, Kane M, Anderson K, Sherman RE. Forces required to initiate sliding in second generation intramedullary nails. J Bone Joint Surg Am. 1998;80(11):1626-31.

Hardy AE. The treatment of femoral fractures by cast-brace application and early ambulation. A prospective review of one hundred and six patients. J Bone Joint Surg Am. 1983;65(1):56-65.

O’Sullivan ME, Chao EY, Kelly PJ. Current concepts review. The effects of fixation on fracture-healing. J Bone Joint S. 1989;71(2):306-10.

Wolinsky PR, McCarty E, Shyr Y, Johnson K. Reamed intramedullary nailing of the femur: 551 cases. J Trauma. 1999;4683:392-9.

Hajek PD, Bicknell HR Jr, Bronson WE, Albright JA, Saha S. 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. J Bone Joint Surg Am. 1993;75(4):519-25.

Wiss DA, Brien WW, Becker V Jr. Interlocking nailing for the tretment of femoral fractures due to gunshot wounds. J Bone Joint Surg Am. 1991;73(4):598-606.

Kwong LM, Johanson PH, Zinar DM, Lenihan MR, Herman MW. Shielding of the patient’s gonads during intramedullary interlocking femoral nailing. J Bone Joint Surg Am. 1990;72(10):1523-6.

Levin PE, Schoen RW Jr, Browner BD. Radiation exposure to the surgeon during closed interlocking intramedullary nailing. J Bone Joint Surg Am. 1987;69(5):761-6.