Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries: A Retrospective Comparative Study

Cheng, Tao; Xia, Ronggang; Dong, Shuang; Yan, Xiaoyu; Luo, Congfeng

doi:10.1080/08941939.2017.1400131

Cited by 7 publications

(12 citation statements)

References 45 publications

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“…Moreover, it may not be always considered the appropriate or recommended surgical procedure such as in juxta-articular or comminuted fractures, revisions of failed femoral unions, and injuries associated with vascular disruption, femoral canal obstruction, or pronounced contamination [7, 8]. In such circumstances, biomechanical analyses have reported sufficient axial and torsional stabilities with plates/screws fixation techniques [17, 24–27].…”

Section: Discussionmentioning

confidence: 99%

“…This surgical technique yielded good functional outcomes in 11 of 16 (68.8%) patients with comminuted distal femoral fracture at one-year follow-up, with one (6.3%) and two (12.5%) individual(s) exhibiting plate failure and infection, respectively [33]. Cheng et al compared dual orthogonal locked plating to interlocking intramedullary nailing in the management of femoral diaphyseal fractures and showed no differences in the rates of complications or bone union [17]. They recommended locked double plating in polytraumatic patients, in whom an interlocking cephalomedullary nail construct is deemed inappropriate.…”

Section: Discussionmentioning

confidence: 99%

“…Single-plate osteosynthesis may be ineffective in achieving adequate reduction of fractures subjected to increased loads, a finding that led some authors to recommend dual plating in such circumstances [9, 10, 15]. Although dual orthogonal plating was shown to be biomechanically and clinically superior to single locked plating in the management of femoral midshaft fractures, there are some technical difficulties associated with this technique, such as the risk of extensive soft-tissue stripping and periosteal circulation disruption [16, 17]. Placing dual plates across a fracture in an adjacent orientation may constitute an alternative fixation requiring less surgical exposure, while possibly providing similar biomechanical stability to orthogonally configured plates.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

Beaino

Lindsey

Gugala

2019

BioMed Research International

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Aim. This study aimed at comparing the mechanical properties of conventional and locking dual plates in adjacent and orthogonal orientations for the surgical fixation of transverse femoral shaft fractures. It also assessed the failure mechanics after dual adjacent and orthogonal locking plate removal. Methods. Thirty-two composite femurs were transversally osteotomized and randomly assigned for fixation with either dual locking or compression plates in an adjacent or orthogonal configuration. Sixteen specimens were preloaded axially to 20 N and single-leg stance loads were simulated. The remaining sixteen constructs were subjected to torsional loads of 10 Nm at a rate of 10 Nm/s in external and internal rotation of the femoral head in relation to the knee. Overall combined rotational stiffness was calculated. Eight different specimens with no osteotomy underwent the same experiments after dual locked plate removal and were tested to failure in combined eccentric axial and torsional modes. Data were statistically processed using a two-tailed t-test and one-way analysis of variance for the comparison of means between two or more groups, respectively. Results. Orthogonal constructs were statistically stiffer in axial loading compared to their adjacent counterparts in both conventional and locking configurations (p<0.001). Dual locking plates provided higher torsional stiffness than conventional ones within each plate orientation (p<0.01). Neither axial/torsional strength nor failure loads differed between constructs that had adjacent or orthogonal dual locking plates instrumented and then removed (p>0.05). Conclusions. In both orthogonal and adjacent orientations, double locking plates provide higher stability than their dual conventional counterparts. Orthogonal dual plate configuration is more stable and biomechanically superior to dual adjacent plating for constructs fixed with either standard compression or locking plates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

Beaino

Lindsey

Gugala

2019

BioMed Research International

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“…The conventional method is for doctors and assistants to reduce the displacement by hand, which is clearly time-consuming and laborious. Moreover, the displacement accuracy is poor, and it requires greater exposure to X-rays, which cause unnecessary damage to both medical personnel and patients [ 7 – 10 ]. Therefore, it is important and urgent for doctors to invent a type of device that can realize the effective reduction of femoral shaft fractures.…”

Section: Introductionmentioning

confidence: 99%

The design of an “H” joystick for closed reduction and its application in segmental and comminuted femoral shaft fractures: an innovative technique

et al. 2020

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Background: Closed reduction and locked intramedullary nailing has become a common surgical method in the treatment of femoral shaft fractures. Overlap and rotation displacements can usually be corrected through the use of an orthopedic traction table. However, lateral displacement and angulation persist. Methods: In this paper, we describe a joystick that can be used in the closed reduction of a fracture. It can correct lateral displacement and angulation, and has the advantage of multi-direction reduction. The device described in this paper includes two parallel horizontal joysticks, one vertical main joystick and four assistant rods. Moreover, there are many specific spacing holes in the two parallel horizontal joysticks and a groove structure in the vertical main joystick. When the main "H" joystick is pressed, it can adjust lateral displacements and angulation because of the lever principle. The distance between parallel horizontal joysticks and assistant rods can be adjusted to the fracture position and body mass index of different patients. Results: The study participants consisted of 11 males and 5 females with a mean age of 31.0 years. All participants had good closed reduction and achieved bony union without any complications such as infection, nerve injury, non-union, malunion, and limb length discrepancy. By using an "H" joystick, closed femoral shaft fracture reduction and locked intramedullary nailing becomes simpler and faster. Conclusion: Based on the use of this instrument, we can easily and conveniently obtain the correct reduction situation, which leads to better surgical results. This device can be applied in the reduction of clinical femoral fractures and gradually extended to the reduction of other fractures.

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“…The conventional method is for doctors and assistants to reduce the displacement by hand, which is clearly time-consuming and laborious. Moreover, the displacement accuracy is poor, and it requires greater exposure to X-rays, which cause unnecessary damage to both medical personnel and patients [7][8][9][10]. Therefore, it is important and urgent for doctors to invent a type of device that can realise the effective reduction of femoral shaft fractures.…”

Section: Introductionmentioning

confidence: 99%

The design of an “H” joystick for closed reduction and its application in segmental and comminuted femoral shaft fractures: an innovative technique

Jia

Wang

Xiao

et al. 2020

Preprint

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Background Closed reduction and locked intramedullary nailing has become a common surgical method in the treatment of femoral shaft fractures. Overlap and rotation displacements can usually be corrected through the use of an orthopaedic traction table. However, lateral displacement and angulation persist. Methods In this paper, we describe a joystick that can be used in the closed reduction of a fracture. It can correct lateral displacement and angulation and has the advantage of multi-direction reduction. The device described in this paper includes two parallel horizontal joysticks, one vertical main joystick and four assistant rods. Moreover, there are many specific spacing holes in the two parallel horizontal joysticks and a groove structure in the vertical main joystick. When the main “H” joystick is pressed, it can adjust lateral displacements and angulation because of the lever principle. The distance between parallel horizontal joysticks and assistant rods can be adjusted to the fracture position and body mass index of different patients. Results The study participants consisted of 11 males and 5 females with a mean age of 31.0 years. All participants had good closed reduction and achieved bony union without any complications such as infection, nerve injury, nonunion, malunion and limb length discrepancy. By using an “H” joystick, closed femoral shaft fracture reduction and locked intramedullary nailing becomes simpler and faster. Conclusion Based on the use of this instrument, we can easily and conveniently obtain the correct reduction situation, which leads to better surgical results. This device can be applied in the reduction of clinical femoral fractures and gradually extended to the reduction of other fractures.

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Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries: A Retrospective Comparative Study

Abstract: Our findings suggest that dual-plating fixation is a promising method for FSFs with multiple injuries. However, the retrospective nature of this study necessitates high-quality trials to be performed to assess the clinical efficiency of dual plating.

Cited by 7 publications

References 45 publications

Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

Biomechanical Evaluation of Dual Plate Configurations for Femoral Shaft Fracture Fixation

The design of an “H” joystick for closed reduction and its application in segmental and comminuted femoral shaft fractures: an innovative technique

The design of an “H” joystick for closed reduction and its application in segmental and comminuted femoral shaft fractures: an innovative technique

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