Intramedullary nailing for femoral shaft fractures in adults

Xiong, Rong; Mai, Qiguang; Yang, Chengliang; Ye, Shu-Xi; Zhang, Xiao; Fan, Shicai

doi:10.1002/14651858.cd010524.pub2

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…Particularly, for long bone fractures, a metallic plate or intramedullary nail is used to stabilize the fracture and provide a suitable environment for fracture healing 1 . Intramedullary nails, typically constructed using high‐strength alloys such as stainless steel and titanium alloys, 2,3 offer solid support for fracture healing. However, these metal alloys are not biodegradable within the bone tissues.…”

Section: Introductionmentioning

confidence: 99%

Fluoride‐treated rare earth‐free magnesium alloy ZK30: An inert and bioresorbable material for bone fracture treatment devices

Watanabe,

Xu,

Uno

et al. 2024

J Biomedical Materials Res

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Bone fractures represent a common health problem, particularly in an increasingly aging population. Bioresorbable magnesium (Mg) alloy‐based implants offer promising alternatives to traditional metallic implants for the treatment of bone fractures because they eliminate the need for implant removal after healing. The Mg‐Y‐rare‐earth (RE)‐Zr alloy WE43, designed for orthopedic implants, has received European Conformity mark approval. However, currently, WE43 is not clinically used in certain countries possibly because of concerns related to RE metals. In this study, we investigated the use of a RE‐free alloy, namely, Mg‐Zn‐Zr alloy (ZK30), as an implant for bone fractures. Hydrofluoric acid (HF) treatment was performed to improve the corrosion resistance of ZK30. HF‐treated ZK30 (HF‐ZK30) exhibited lower corrosion rate and higher biocompatibility than those of WE43 in in vitro experiments. After implanting a rod of HF‐ZK30 into the fractured femoral bones of mice, HF‐ZK30 held the bones and healed the fracture without deformation. Treatment results of HF‐ZK30 were comparable to those of WE43, indicating the potential of HF‐ZK30 as a bioresorbable and safe implant for bone repair.

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Section: Introductionmentioning

confidence: 99%

Fluoride‐treated rare earth‐free magnesium alloy ZK30: An inert and bioresorbable material for bone fracture treatment devices

Watanabe,

Xu,

Uno

et al. 2024

J Biomedical Materials Res

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show abstract

“…In such cases, FSF could be compounded by other life-threatening injuries that require urgent interventions and so the primary definitive fixation of the femur could be delayed [ 5 ]. The vast majority FSF are closed (91%), in which the surrounding tissues remain intact, whereas a lesser proportion constituted open type (9%) [ 1 , 6 ], presented with exposed bone, which are considered serious due to the higher risk of wound contamination and sepsis [ 7 ]. The FSF could be treated conservatively or managed surgically, by plate or intramedullary nail (IMN) fixation [ 2 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The vast majority FSF are closed (91%), in which the surrounding tissues remain intact, whereas a lesser proportion constituted open type (9%) [ 1 , 6 ], presented with exposed bone, which are considered serious due to the higher risk of wound contamination and sepsis [ 7 ]. The FSF could be treated conservatively or managed surgically, by plate or intramedullary nail (IMN) fixation [ 2 , 7 ]. Notably, IMN is the standard of care, as it is less invasive and possesses a lower risk of in-hospital complications [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Traumatic Femur Fractures: A Focus on the Time to Intramedullary Nailing and Clinical Outcomes

et al. 2023

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Background: Femur shaft factures (FSF) are common injuries following high-energy mechanisms mainly involving motor vehicle crashes (MVC). We evaluated the timings of nailing management and analyzed the pattern of fracture union and outcome in a level 1 trauma center. Methods: This was a retrospective observational study of all the admitted trauma patients who sustained femoral fractures between January 2016 and September 2020. Data were analyzed and compared based on time to Intramedullary Nailing (IMN) (<12 h, 12–24 h and >24 h) and outcomes of FSF (union, delayed union and nonunion). Results: A total of 668 eligible patients were included in the study, of which the majority were males (90.9%) with a mean age of 34.5 ± 15.8, and 54% of the injuries were due to MVCs. The chest (35.8%) was the most commonly associated injured body region, followed by the pelvis (25.9%) and spine (25.4%). Most of femur fractures (93.3%) were unilateral, and 84.4% were closed fractures. The complete union of fractures was observed in 76.8% of cases, whereas only 4.2% and 3.3% cases had delayed union and nonunion, respectively, on the clinical follow-up. Patients in the delayed IMN (>24 h) were severely injured, had bilateral femur fracture (p = 0.001) and had higher rate of external fixation, blood transfusion, pulmonary complications and prolonged hospitalization. Non-union proportion was greater in those who had IMN <24 h, whereas a delayed union was greater in IMN done after 24 h (p = 0.5). Those with a nonunion femur fracture were more likely to have bilateral fracture (p = 0.003), frequently had retrograde nailing (p = 0.01), and high-grade femur fracture (AO type C; p = 0.04). Conclusion: This study showed that femur fracture is not uncommon (8.9%), which is manifested with the variety of clinical characteristics, depending on the mechanism, management and outcome in our center. Bilateral fracture, retrograde nailing and AO classification type C were the significant risk factors of non-union in patients with diaphyseal fractures. The timing of IMN has an impact on the fracture union; however, it is not a statistically significant difference. Therefore, the treating physicians should consider the potential risk factors for a better outcome by careful selection of treatment in sub-groups of patients.

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Intramedullary nailing as a treatment for non-unions of femoral shaft fractures after plating failure: A case series

Oesman¹,

Kurniawan²,

Canintika³

2023

International Journal of Surgery Case Reports

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Intramedullary nailing for femoral shaft fractures in adults

Cited by 7 publications

References 15 publications

Fluoride‐treated rare earth‐free magnesium alloy ZK30: An inert and bioresorbable material for bone fracture treatment devices

Fluoride‐treated rare earth‐free magnesium alloy ZK30: An inert and bioresorbable material for bone fracture treatment devices

Management of Traumatic Femur Fractures: A Focus on the Time to Intramedullary Nailing and Clinical Outcomes

Intramedullary nailing as a treatment for non-unions of femoral shaft fractures after plating failure: A case series

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