Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: Effectiveness and timing

Megas, Panagiotis; Syggelos, Spyros A.; Kontakis, Georgios; Giannakopoulos, Andreas; Skouteris, G.; Lambiris, E.; Panagiotopoulos, Elias

doi:10.1016/j.injury.2008.11.008

Cited by 17 publications

(21 citation statements)

References 24 publications

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“…24 Megas et al observed a consolidation rate of 100% when treating non-unions of the femoral shaft by intramedullary nailing. 25,26 Numerous other authors have in recent years reported similar consolidation rates when using exchange nailing in aseptic non-unions of the femoral shaft. [27][28][29] In contrast to our collective, these studies consisted mainly of hypertrophic non-unions and needed no highly specialised treatment.…”

Section: Consolidation In One-step Treatment (G1)mentioning

confidence: 89%

“…This produces good results, but is a demanding procedure that requires microsurgical techniques. 26,41 A combination with an Ilizarov external fixator has also been shown to produce good results. Lai et al reported its successful application on five young patients with very large osseous defects in distal femoral non-unions (F defect size 15.8 cm).…”

Section: Consolidation In Two-step Treatment (G2)mentioning

confidence: 99%

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Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

Moghaddam

Thaler

Brückner

et al. 2017

Journal of Orthopaedics

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Section: Consolidation In One-step Treatment (G1)mentioning

confidence: 89%

Section: Consolidation In Two-step Treatment (G2)mentioning

confidence: 99%

Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

Moghaddam

Thaler

Brückner

et al. 2017

Journal of Orthopaedics

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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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Are polymorphisms of molecules involved in bone healing correlated to aseptic femoral and tibial shaft non‐unions?

Zeckey

Hildebrand

Glaubitz

et al. 2011

Journal Orthopaedic Research

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Fracture healing is a well-organized process between several molecules and mediators. As known from other diseases, genetic polymorphisms may exhibit different expression patterns in these mediators. Concerning fracture healing, this may lead to an extended healing process or non-union. We investigated the incidence of polymorphisms in patients with aseptic non-unions after femoral and tibial shaft fractures as compared to patients with uneventful healing. Exclusion criteria were smoking, diabetes, bilateral fractures, systemic corticoid therapy, and septic non-unions. Analysis of allele frequencies and genotype distribution of various mediators were carried out following PCR. Clinical parameters such as injury severity and in-hospital were analyzed. Fifty patients following non-union (group NU) were enrolled, the control group consisted of 44 patients (group H). A significant association of a PDGF haplotype and non-unions following fracture could be observed. There was a significantly increased in-hospital time and amount of surgical procedures in group NU. Polymorphisms within the PDGF gene seem to be a genetic risk factor for the development of nonunions of the lower extremity following fracture. The early identification of high risk patients could result in an adapted therapeutical strategy and might contribute to a significant decrease of posttraumatic non-unions. ß

show abstract

Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: Effectiveness and timing

Cited by 17 publications

References 24 publications

Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

Treatment of atrophic femoral non-unions according to the diamond concept: Results of one- and two-step surgical procedure

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

Are polymorphisms of molecules involved in bone healing correlated to aseptic femoral and tibial shaft non‐unions?

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