Closure of the femoral medullary canal after retrograde nailing using an in-situ osteochondral autograft–Technical trick and a case series

Çepni, Şahin; Veizi, Enejd; Erdoğan, Yasin; Şahin, Ali; Fırat, Ahmet; Kılıçarslan, Kasım

doi:10.1016/j.injury.2021.10.030

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Cepni et al have used a manual trepan for reaming, which is a laborious process. Moreover, the lack of guide pin and depth-limiting device leads to the possibility of deflection of the opening direction [ 6 ]. The new trephine we designed is more accurate and not too deep under the guidance of the guide pin.…”

Section: Discussionmentioning

confidence: 99%

“…The hollow trephine has been used during proximal femoral intramedullary nailing procedures [ 5 ]. Cepni et al have also tried reaming with a manual trephine and closed the channel with a bone bolt after fixation [ 6 ]. We have designed a hollow trephine with limited depth measurement and used it during retrograde intramedullary femoral nailing in 11 patients.…”

Section: Introductionmentioning

confidence: 99%

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The application of a hollow trephine in femoral retrograde intramedullary nailing technique

Yao

Liu

et al. 2023

BMC Musculoskelet Disord

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Purpose The purpose of this study was to describe and evaluate the use of a specially designed hollow trephine to create the entry point through the femoral condyle during retrograde interlocking intramedullary nailing for femoral fractures. Methods From June 2019 to December 2021, we treated 11 patients (5 men, 6 women; mean age, 64 years; age range 40–77 years) with mid-distal femoral fractures by retrograde intramedullary femoral nailing using a self-designed hollow trephine for femoral condyle reaming and cancellous bone harvesting. The mode of all the nails is static. Patients were followed up at 1, 4, 8, and 12 weeks and for at least 6 months after surgery. The healing process and heterotopic ossification were evaluated by imaging. Partial weight bearing was permitted during the recovery period and complete weight bearing was permitted after clinical healing of the fracture displayed by X-ray. Results The operation was successful in all patients. Over mean follow-up of 9.3 months (range, 6.0–12.0 months), all patients achieved clinical healing within three months. There were no complications such as knee joint infection, heterotopic ossification, knee joint adhesion and wedge effect. Conclusion The use of the hollow trephine during femoral retrograde intramedullary nailing helps avoid postoperative complications such as heterotopic ossification, knee joint adhesions, and wedge effect. It also facilitates bone graft harvesting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The application of a hollow trephine in femoral retrograde intramedullary nailing technique

Yao

Liu

et al. 2023

BMC Musculoskelet Disord

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“… 10 Several studies have indicated a significant occurrence of knee pain with estimates ranging from 20% to 86% and even 17% of the patients may experience moderate-to-severe pain years after surgery. 14 , 15 Brewster, 16 in his systematic review, stressed that 40–53% of the individuals who had retrograde intramedullary nailing may experience knee discomfort.…”

Section: Introductionmentioning

confidence: 99%

Knee Pain After Retrograde Intramedullary Nailing with Surgical Implant Generation Network of Femur Shaft Fractures at Public Hospitals in Bahir Dar City, Ethiopia: Analysis of 6-Months Follow-Up Results

Birlie¹,

Biresaw²,

Yadeta³

et al. 2023

ORR

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Background The incidence of femur fractures in young and elderly people has increased, particularly in countries with limited resources like Ethiopia. Intra-medullary nailing (IM) has been an effective and cost-effective method of treating long bone shaft fractures, but it can lead to complications such as knee pain. Purpose This study aimed to evaluate knee pain and its associated factors following retrograde intramedullary nailing for femur fractures. Patients and Methods The study followed 110 patients diagnosed with femur fractures and treated with retrograde SIGN Standard Nail or Fin Nail from January 2020 to December 2022 at two hospitals in Ethiopia. The patients were followed up for at least 6 months, and data were collected from medical charts, patient interviews, and phone calls to patients who did not attend the follow-up appointment. Binary logistic regression analysis was used to identify factors associated with knee pain. Results The study showed that 40 patients reported knee pain at 6-months follow-up, making a prevalence of 36.4%. Factors significantly associated with knee pain were a time of injury to nailing (AOR=4.23, 95% CI: 1.28–13.92), use of a screw to the medial cortex (AOR=9.30, 95% CI: 2.90–12.74), and fracture site (AOR= 2.67, 95% CI: 14.01–7.03). Specifically, the longer the time from injury to nailing, the higher the risk of knee pain. The use of a longer screw to the medial cortex and a fracture site were also positively associated with knee pain. Conclusion This study concludes that although retrograde intramedullary nail fixation is an effective method for femur fractures, it often results in knee pain. Approximately 4 of 10 patients suffered from knee pain in this study. Avoiding delayed surgical management and minimizing the use of prominent metalwork may reduce knee pain.

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The application of hollow trephine in femoral retrograde intramedullary nailing technique

Yao

Liu

et al. 2022

Preprint

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Purpose The purpose of this study was to describe and evaluate the use of a specially designed hollow trephine to create the entry point through the femoral condyle during retrograde interlocking intramedullary nailing for femoral fracture. Methods From June 2019 to December 2021, we treated 11 patients (5 men, 6 women; mean age, 64 years; age range 40–77 years) with mid-distal femoral fractures by retrograde intramedullary femoral nailing using a self-designed hollow trephine for femoral condyle reaming and cancellous bone harvesting. Results The operation was successful in all patients. Over mean follow-up of 9.3 months (range, 6.0–12.0 months), all patients achieved bone union. There were no complications such as knee joint infection, heterotopic ossification, knee joint adhesion, and wedge effect. Conclusion The use of the hollow trephine during femoral retrograde intramedullary nailing helps avoid postoperative complications such as heterotopic ossification, knee joint adhesions, and wedge effect. It also facilitates bone graft harvesting.

show abstract

Closure of the femoral medullary canal after retrograde nailing using an in-situ osteochondral autograft–Technical trick and a case series

Cited by 3 publications

References 14 publications

The application of a hollow trephine in femoral retrograde intramedullary nailing technique

The application of a hollow trephine in femoral retrograde intramedullary nailing technique

Knee Pain After Retrograde Intramedullary Nailing with Surgical Implant Generation Network of Femur Shaft Fractures at Public Hospitals in Bahir Dar City, Ethiopia: Analysis of 6-Months Follow-Up Results

The application of hollow trephine in femoral retrograde intramedullary nailing technique

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