Aim: Distal femur fractures can be treated with modern anatomic plates and nails. This study aimed to examine the clinical and radiological results of displaced distal femur fractures in adult people who had been treated with a retrograde intramedullary nail (RIN).
Material and Methods:The study included all patients who underwent RIN surgery for distal femur fracture between January 2013 and April 2018 in a level 3 trauma center. Patients were divided into two groups based on fracture pattern: open fracture and closed fracture. The preoperative and postoperative clinical, radiological and functional characteristics of patients who had RIN for a distal femur fracture were analyzed. Results: Thirty patients were included in the study. 21 (70%) patients were male. The median age of the patients was 39 (range, 18-58) years. 17 (56.7%) of the affected femur were left-sided. The etiology of the fractures was traffic accident and fall in 19 (63.3%) patients and gunshot injury in 11 (36.7%) patients. Of the patients, 17 (56.7%) were closed fractures and 13 (43.3%) were open fractures. There were no significant differences between two groups related to the surgery time (p=0.086), fluoroscopy time (p=0.805), blood loss (p=0.967), and hospitalization time (p=0.967), clinical pain and function scores (p=0.341, p=0.902), and union time (p=0.385) at the postoperative period. Conclusion: RIN is a minimally invasive method that may prevent excessive blood loss and decrease the duration of surgery time. It is an effective and reliable surgical intervention that should be considered for the treatment of distal femur fractures.
This study aimed to determine and compare the effects of two different gastric residual volume (GRV) thresholds, 200 mL and 400 mL, on target calories and gastrointestinal intolerance in intensive care patients receiving enteral nutrition. Materials and Methods: Prospective data of 56 patients over 18 years of age who were expected to stay in the intensive care unit for more than three days were included in the study. Patients were randomized into two groups as GRV threshold 200 mL (group 1) and GRV 400 mL (group 2). Enteral Measurement of GRV was done every six hours. The feeding was initiated at a rate of 20 mL/h and was increased by 10 mL/h to reach the goal rate. Results: There was no significant difference between two groups regarding gender, age, APACHE II score, body mass index, length of stay in intensive care unit, admission reason, and co-morbidities. There was also no significant difference in the incidence of GRV, vomiting, diarrhea and intolerance. Time to target calories was 24 hours in group 1 and 26 hours in group 2, and no significant difference was found between the two groups. Conclusion: In this study, there was no significant difference between 200 mL and 400 mL GRV regarding time to target calories and incidence of gastrointestinal complications in critical intensive care unit patients.
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