Femoral exchange nailing for aseptic non-union: not the end to all problems

Banaszkiewicz, Paul A.; Sabboubeh, Adel; McLeod, Ian; Maffulli, Nicola

doi:10.1016/s0020-1383(02)00191-2

Cited by 71 publications

(63 citation statements)

References 17 publications

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“…According to the study reported by . Nonunion following comminuted fractures do not appear to respond to exchange nailing as favorably as nonunion occurring after simple transverse or oblique fractures 2,11) .…”

Section: Methodsmentioning

confidence: 99%

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Treatment of the Femoral Shaft Nonunion Occurred after Intramedullary Nailing

Jung

Kim

et al. 2007

J Korean Orthop Assoc

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골수강 금속정 고정술 후 발생한 대퇴골 간부 불유합의 치료 정현균ㆍ김대중ㆍ김병학ㆍ정영율 광주기독병원 정형외과Purpose: To evaluate of efficacy of the treatment options for a femoral shaft nonunion occurring after intramedullary nailing. Material and Methods: Thirty-one patients with nonunion of a femoral shaft fracture, who had been treated with interlocking intramedullary nailing from January 1996 to December 2000, were examined. Twenty-six had oligotrophic nonunion and five were hypervascular. Forty-five procedures were performed for 31 nonunions; bone grafting for 14, exchange nailing for 13, plate augmentation and bone grafting for 14 and dynamization for 4 cases. Results: The success rate after a single procedure was only 58%. The four dynamization cases failed to unite. Seven of the 13 (54%) nonunion cases treated with nail exchange healed satisfactorily. All cases treated with plate augmentation and bone grafting achieved successful union. The mean period from fracture to union was 20 months. Conclusion: Exchange nailing is not always a reliable procedure for treating nonunion of a femoral shaft fracture. Plate augmentation and bone grafting were found to be a successful mode of therapy for the femoral shaft nonunion without complications.

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Section: Methodsmentioning

confidence: 99%

“…Interlocking nailing provides more rotational stability for fixation of the fracture. Closed intramedullary nailing is a recent treatment for femoral shaft fractures 2,17) .…”

Section: Introductionmentioning

confidence: 99%

Treatment of the Femoral Shaft Nonunion Occurred after Intramedullary Nailing

Jung

Kim

et al. 2007

J Korean Orthop Assoc

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Section: Wstępunclassified

“…Intramedullary nailing is a possible technique both in primary and secon dary (revision surgery) treatment [15]. In the latter case nailing with reaming is a gold standard of treatment, although some works have questioned its status [7,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…Jed ną z mo żli wych tech nik jest sto so wa nie gwoź dzi śród sz pi ko wych zarów no w le cze niu pier wot nym, jak i wtór nym (re opera cyj nym) [15]. W tym dru gim przy pad ku gwoź dziowa nie z roz wier ce niem otwo ru pier wot ne go sta no wi zło ty stan dard le cze nia, cho ciaż po ja wia ją się pra ce, w któ rych jest to kwe stio no wa ne [7,[16][17][18].Po now ne gwoź dzio wa nie to tech ni ka z wy bo ru, po nie waż przy znacz nej utra cie ma te ria łu kost ne go w przy pad ku sta wu rze ko me go atro ficz ne go, wsz cze py kost ne nie ma ją dla sie bie efek tyw ne go pod ło ża i przycze pu. Do pod sta wo wych czyn ni ków wa run ku ją cych wła ści wy zrost kost ny na le żą od po wied nia re po zy cja odła mów oraz od two rze nie wa sku la ry za cji [10,19,20].…”

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Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

Słowiński

Kudłacik²

2016

Ortop Traumatol Rehabil

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Po wi kła nie zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi ko wym -nu me rycz na ana li za przy pad ku kli nicz ne go STRESZ CZE NIECe lem pra cy by ła nu me rycz na ana li za przy pad ku zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi kowym i po twier dze nie wa run ków, któ re do pro wa dzi ły do wy kształ ce nia sta wu rze ko me go w miej scu zła ma nia.Ni sko ener ge tycz ne zła ma nie ko ści udo wej sta bi li zo wa no za po mo cą śród sz pi ko we go gwoź dzia krę ta rzo we go ChFN Sys tem z pi nem de ro ta cyj nym. Z wy ko rzy sta niem me to dy ele men tów skoń czo nych opra co wa ny zo stał układ kość -im plant, któ ry umo żli wił ob ser wa cję po la prze miesz czeń oraz od kształ ceń w re jo nie szcze li ny zła ma nia. Ob licze nia prze pro wa dzo no na 3 wa rian tach mo de lu, z gwoź dziem ty ta no wym (10 mm i 12 mm) oraz sta lo wym (10 mm). Ana li za roz kła du od kształ ceń wska za ła, że naj więk sze ich war to ści lo ka li zu ją się w szcze li nie zła ma nia i są wy ższe w przy pad ku za sto so wa nia im plan tu ze sto pu ty ta nu (0-17% vs 0-11%). Ru chy mię dzy odła mo we po wo do wa ne przyło żo nym ob cią że niem by ły ta kże wy ższe w przy pad ku za sto so wa niu im plan tu ze sto pu ty ta nu. Ana li za od kształ ceń wska za ła, że od se tek ele men tów w ob sza rze szcze li ny, po ten cjal nie zdol nych do two rze nia tkan ki kost nej jest wyższy w przy pad ku za sto so wa nia im plan tu sta lo we go.Mo żli we jest wska za nie miejsc, w któ rych zaj dzie nie ko rzyst na od bu do wa szcze li ny zła ma nia, co mo że do prowa dzić do po wsta nia sta wu rze ko me go. Za sto so wa nie im plan tu sta lo we go pod no si praw do po do bień stwo uzy ska nia sta bil ne go zro stu kost ne go.Słowa kluczowe: MeSH, hip frac tu res, pseu dar th ro sis, com pu ter si mu la tion SUMMARYThe aim of this paper is to conduct a numerical analysis of a case of femoral fracture treated by intramedullary nailing and confirm the conditions which led to the formation of a pseudarthrosis at the fracture site.A low-energy femoral fracture was treated by placing a ChFN System intramedullary nail with a derotation pin. Using the finite element method, a bone-implant system was generated which made it possible to observe the dis placement area and strains in the region of the fracture gap. The calculations were conducted for 3 variants of the model, using a titanium nail (10 mm and 12 mm) and a steel one (10 mm). Analysis of strain distribution indicated that the highest strain values occur in the fracture gap and that they are higher when a titanium alloy is used (0-17% vs 0-11%). Interfragmentary movements caused by an imposed load were also higher when a titanium alloy implant was used. Strain analysis showed that the percentage of elements in the gap area which are potentially able to grow bone tissue is higher when a steel implant is used.It is possible to indicate sites where unfavourable fracture gap healing will take place, which may lead to the deve lopment of a pseud...

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Nonunion

Hierholzer¹,

Bühren²

2014

Intramedullary Nailing

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Femoral exchange nailing for aseptic non-union: not the end to all problems

Cited by 71 publications

References 17 publications

Treatment of the Femoral Shaft Nonunion Occurred after Intramedullary Nailing

Treatment of the Femoral Shaft Nonunion Occurred after Intramedullary Nailing

Complication of a Femoral Fracture Treated by Intramedullary Nailing - Numerical Analysis of a Clinical Case

Nonunion

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