Backstroke technique: an effective way to improve the healing of tibia fracture

Lee, Qi; Zeng, Bingfang; Luo, Congfeng; Wang, Jinwu; Lü, Nonghua

doi:10.1007/s00264-006-0090-2

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…This finding is consistent with the results of previous studies in which nonunion was more common with large interfragmentary gaps in comminuted femoral shaft fractures 27 – 29 , and in another study which reported a fracture site gap greater than 2 mm as a risk factor for nonunion 21 . Reducing the residual gap in femur shaft segmental fractures is suggested to be an important factor for obtaining favorable outcomes 30 , 31 . In all of nonunion patients in our study, only one side of the segment did not unite after operation.…”

Section: Discussionmentioning

confidence: 99%

A multicenter study of factors affecting nonunion by radiographic analysis after intramedullary nailing in segmental femoral shaft fractures

Kook

Park

Kim

et al. 2023

Sci Rep

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The factors affecting the outcomes of segmental femoral shaft fractures are currently unknown. We evaluated the outcomes of intramedullary (IM) nail fixation and investigated factors affecting nonunion of femoral shaft segmental fractures. A total of 38 patients who underwent IM nail fixation for femoral shaft segmental fractures (AO/OTA 32C2) at three university hospitals with a minimum 1-year follow-up period were retrospectively reviewed. The patients were divided into union (n = 32) and nonunion (n = 6) groups. We analyzed smoking status, diabetes mellitus, location of the segmental fragment, segment comminution, filling of the IM nail in the medullary canal, residual gap at the fracture site, use of a cerclage wire or blocking screws as factors that may affect the surgical outcome. In the union group, the average union time was 5.4 months (4–9 months). In the nonunion group, five patients required additional surgery within an average of 7.2 months (5–10 months) postoperatively, whereas one patient remained asymptomatic and did not require further intervention. On comparing the two groups, insufficient canal filling of the IM nail (union, 25.0%; nonunion, 83.3%; p = 0.012) and the presence of a residual gap at the fracture site after reduction (union, 31.3%; nonunion, 83.3%; p = 0.027) were significantly different. In the multivariate analysis, only insufficient canal filling of the IM nail was found to be a factor affecting nonunion, with an odds ratio of 13.3 (p = 0.036). In this study, a relatively high nonunion rate (15.8%) was observed after IM nail fixation. Insufficient IM nail canal filling and a residual gap at the fracture site post reduction were factors affecting segmental femoral shaft fracture nonunion after IM nail fixation.

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Section: Discussionmentioning

confidence: 99%

A multicenter study of factors affecting nonunion by radiographic analysis after intramedullary nailing in segmental femoral shaft fractures

Kook

Park

Kim

et al. 2023

Sci Rep

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show abstract

“…This nding is consistent with the results of previous studies in which nonunion were more common with large interfragmentary gaps in comminuted femoral shaft fractures [27][28][29] , and in another study reported as risk factors for nonunion when the fracture site gap was greater than 2mm 21 . Reducing the residual gap in femur shaft segmental fractures is suggested to be an important factor for obtaining favorable outcomes 30,31 . In all of nonunion patients in our study, only one side of the segment did not unite after operation.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is a report that there is no difference in union rate and infection rate in open and closed IM nail xation 32 , however, segmental femoral shaft fracture is a high-energy injury, so caution is needed to perform open reduction, and surgical procedures to minimize soft tissue injury are required. Rather than using open reduction to reduce the residual gap, other methods such as various percutaneous reduction techniques and forward or backward striking techniques are considered to have advantages 30,31 .…”

Section: Discussionmentioning

confidence: 99%

Radiographic outcomes and factors affecting nonunion after intramedullary nailing in femur segmental fracture: a multicenter study

Kook

Park

Kim

et al. 2022

Preprint

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Factors affecting the outcomes of femoral shaft segmental fractures are currently unknown. We evaluated the outcomes after intramedullary (IM) nail fixation and investigated the factors affecting nonunion in femoral shaft segmental fractures. A total of 38 patients who underwent IM nail fixation for femoral shaft segmental fractures (AO/OTA 32C2) at three university hospitals with a minimum 1-year follow-up was reviewed retrospectively. All patients were divided into the union group (n = 32) and the nonunion group (n = 6). We analyzed smoking status, diabetes mellitus, location of the segmental fragment, segment comminution, filling of the IM nail in the medullary canal, residual gap at the fracture site, use of a cerclage wire or blocking screws as factors that may affect the surgical outcome. In the union group, the average union time was 5.4 months (4–9 months). In the nonunion group, five cases underwent additional surgery at an average of 7.2 months (5–10 months) postoperatively, and one case was asymptomatic and followed-up without surgery. In the comparison of the union and nonunion group, insufficient canal filling of the IM nail (union: 25.0%, nonunion: 83.3%, p = 0.012) and residual gap at the fracture site after reduction (union: 31.3%, nonunion: 83.3%, p = 0.027) showed a significant difference. In multivariate analysis, insufficient canal filling of the IM nail was found to be a factor affecting nonunion, with an odds ratio of 13.3 (p = 0.036). After IM nail fixation for femoral shaft segmental fractures, a relatively high nonunion rate (15.8%) was observed. Factors affecting nonunion were insufficient canal filling of IM nail and residual gap of fracture site.

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“…For seven fractures in the midshaft group with delayed union and a postoperative fracture gap of more than 2 mm, the backstroke technique was not or inefficiently performed. A remaining postoperative fracture gap in intramedullary nailing is known as a major risk factor for delayed and nonunion [29,30].…”

Section: Discussionmentioning

confidence: 99%

A multicentre case series of tibia fractures treated with the Expert Tibia Nail (ETN)

Attal

Hansen

Kirjavainen

et al. 2012

Arch Orthop Trauma Surg

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Backstroke technique: an effective way to improve the healing of tibia fracture

Cited by 8 publications

References 15 publications

A multicenter study of factors affecting nonunion by radiographic analysis after intramedullary nailing in segmental femoral shaft fractures

A multicenter study of factors affecting nonunion by radiographic analysis after intramedullary nailing in segmental femoral shaft fractures

Radiographic outcomes and factors affecting nonunion after intramedullary nailing in femur segmental fracture: a multicenter study

A multicentre case series of tibia fractures treated with the Expert Tibia Nail (ETN)

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