Femoral-Shaft Fractures Treated by Medullary Nailing

Cave, Edwin F.

doi:10.1056/nejm195202212460802

Cited by 8 publications

(3 citation statements)

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“…Long proximal femur nail (PFN) spans the entire femur with good stability and helps in early mobilization. When subtrochanteric femur fractures occur in patients with PDB, intramedullary nails are usually preferred for surgical stabilization [ 10 , 11 ]. Due to pathology in the bone, delayed compromised bone healing, implants may fail due to more load over the implant for an extended period of time if the fracture does not unite.…”

Section: Discussionmentioning

confidence: 99%

Subtrochanteric Femur Fracture in Monostotic Pagets Disease and its Management – A Case Report and Review of Literature

Mahajan¹,

Sadar²,

S³

et al. 2021

JOCR

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Introduction: Paget disease of bone is a chronic progressive disease of the bone of uncertain etiology, characterized initially by an increase in bone resorption, followed by a disorganized and excessive formation of bone, leading to pain, fractures, and deformities. It can manifest as a monostotic or polyostotic disease. Pathological fracture secondary to Paget’s disease requires surgical management. Case Report: A 60-year-old male patient came with complaint of pain and swelling over the left hip for 30 days. The patient had a history of a trivial fall. Radiological investigations were suggestive of pathological subtrochanteric femur fracture with Paget’s disease of the left femur. We managed with the long proximal femoral nail (PFN). Histopathological examination confirmed the diagnosis of Paget’s disease. At present 1-year follow-up, the patient is having good radiological and functional outcome with no implant failure. Conclusion: Subtrochanteric pathological femur fractures in Paget’s disease are best managed with the long PFN with good outcome and fewer complications, which help in early mobilization and weight-bearing. Long PFN spans the entire pathologic femur and prevents the secondary fractures. Keywords: Pagets disease, femur subtrochanteric fracture, long proximal femur nail.

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Section: Discussionmentioning

confidence: 99%

Subtrochanteric Femur Fracture in Monostotic Pagets Disease and its Management – A Case Report and Review of Literature

Mahajan¹,

Sadar²,

S³

et al. 2021

JOCR

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“…1,4,5,7 In light of this study, prophylactic internal fixation of a select group of unfractured femurs containing symptomatic metastatic mammary cancer lesions could be carried out with minimal morbidity and no adverse effect on survival. The incidence of subsequent fracture of this select group with symptomatic lesions is sufficiently high and the benefits derived from internal stabilization are great enough to warrant a controlled clinical trial.…”

Section: Ember 1970mentioning

confidence: 98%

The natural history and management of mammary cancer metastatic to the femur

Knutson

Spratt

1970

Cancer

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In this study an attempt is made to evaluate the natural history of patients with mammary cancer metastatic to the femur and to identify those methods of management which are most effective. Forty‐six patients with 66 different femoral metastases were reviewed retrospectively from the Ellis Fischel State Cancer Hospital. The total incidence of long‐bone metastasis secondary to mammary cancer in 2,951 patients was 3.45% with 90% involving the femur, and 75% of all femoral lesions were associated with other bony metastasis. Fractures occurred, at some time, in 42.4% of all femoral metastasis. Fractures were not present initially in 51 lesions evaluated, but 38 of these were symptomatic and fractures subsequently occurred in 34.2% of the symptomatic lesions. Regardless of the mode of therapy, a statistically significant difference in survival was not found in patients who sustained pathologic fractures when compared to those who did not, nor did internal fixation of fractures alter survivals. A 50% improvement in the level of ability to ambulate was noted in the fracture group, due solely to internal fixation, whereas the non‐fracture and non‐surgically treated patients showed only a 2.6% improvement in ambulatory level. The authors conclude that prophylactic internal fixation merits more consideration in the management of patients with symptomatic femoral metastasis secondary to advanced mammary cancer.

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“…Apart from technical descriptions, American surgeons were skeptical in using endomedullary nailing of long-bone fractures, requiring about twenty years to be fully accepted in North America and England. But, as Edwin F. Cave, chief of Fracture Service of the Massachusetts General Hospital commented in 1952: "This, I think, is fortunate, as the slow acceptance of this technique has allowed us to avoid many pitfalls that would have discouraged us as surgeons and would have led to abandonment of a procedure that is one of the great advances in fracture treatment during this century" [7]. For he who walks for a long time a well-known and comfortable path, it may be difficult to fully comprehend and appreciate a new road.…”

mentioning

confidence: 99%

Kuntscher Nail: The Rod Who Flied From Germany Inside the Legs of America

Emilio¹

2012

Emergency Medicine

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Femoral-Shaft Fractures Treated by Medullary Nailing

Cited by 8 publications

References 1 publication

Subtrochanteric Femur Fracture in Monostotic Pagets Disease and its Management – A Case Report and Review of Literature

Subtrochanteric Femur Fracture in Monostotic Pagets Disease and its Management – A Case Report and Review of Literature

The natural history and management of mammary cancer metastatic to the femur

Kuntscher Nail: The Rod Who Flied From Germany Inside the Legs of America

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