Intramedullary Nailing of Femoral Shaft Fractures

Warmbrod, J G; Yelton, Chris; Weiss, Andrew B.

doi:10.1097/00003086-197601000-00033

Cited by 5 publications

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“…The average time to union in nailing group of 16.43 ± 2.48 weeks reported by Shrestha et al [12] and 16.5 weeks reported by Deepak et al [16] also agree with the findings of this study. The overall bone union rate of 100% noted in the intramedullary nailing group in the study also agrees with the already documented rate of 97% to 100% following locked intramedullary nailing in most series [16,17]. Similarly, the time of Table 5 shows that all the fractures in the locked intramedullary nailing group had bridging callus in at least three cortices in the fracture site at 12 weeks while only 22 (84.6%) of fractures in the plating group showed similar effect between 12 and 18 weeks.…”

Section: Discussionsupporting

confidence: 91%

Comparative prospective study of early outcomes after osteosynthesis with locked intramedullary nailing or plating for closed femoral shaft fractures at the National Orthopaedic Hospital Enugu, Nigeria

Ekwunife¹,

Iyidobi²,

Enweani

et al. 2020

International Orthopaedics (SICOT)

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Aim of the study This was to compare the early outcome of closed femoral shaft fractures treated with locked intramedullary nailing and plating at the National Orthopaedic Hospital Enugu. Methods The study was a prospective study over 12-month period at the National Orthopaedic Hospital Enugu. Ethical clearance was obtained from the hospital ethical committee. Written informed consent was obtained from all prospectively recruited participants. Patients who met the inclusion criteria were randomly selected by simple balloting into either intramedullary nailing group or plating group. The patients were evaluated at presentation and postoperatively within 48 hours, then at two weeks, six weeks, 12 weeks and 18 weeks, respectively. Participants were evaluated using Thoresen criteria. Results A total of 52 femoral shaft fractures in 50 patients were included and analysed using SPSS version 20.0. Bone union was obtained in all the patients in the intramedullary nailing group at 12 weeks and in 84.6% patients in the plating group between 12 and 18 weeks. The overall wound infection rate was 11.5% in the locked intramedullary group and 7.7% in the plating group. Similarly, the overall limb length discrepancy was 11.5% in the locked intramedullary nailing group and 19.2% in the plating group. Based on the Thoresen criteria, good to excellent outcome was achieved in 65.4% of patients in the locked intramedullary nailing group. Discussion The patients in both groups were evaluated clinically, radiologically and functionally based on the Thoresen criteria and significantly higher number of patients in the intramedullary nailing group (17; 65.4%) than the plating group had good to excellent outcome (x 2 = 9.734; p = 0.020). Conclusion The early outcome of treatment of closed femoral shaft fractures in adults is significantly better following locked intramedullary nailing than plating.

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Section: Discussionsupporting

confidence: 91%

Comparative prospective study of early outcomes after osteosynthesis with locked intramedullary nailing or plating for closed femoral shaft fractures at the National Orthopaedic Hospital Enugu, Nigeria

Ekwunife¹,

Iyidobi²,

Enweani

et al. 2020

International Orthopaedics (SICOT)

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“…This was similar to the average time of bone union of femoral shaft fractures following internal fixation reported by Salminen in his study [26]. The overall bone union rate of 92.3% found in the study at 18 weeks also agrees with the overall rate of 90% -100% reported by Magerl et al [22] and Warmbrod et al [27] in their series.…”

Section: Discussionsupporting

confidence: 91%

Epidemiological Pattern of Closed Femoral Shaft Fractures in a Regional Tertiary Hospital in Enugu, Nigeria

Iyidobi¹,

Ekwunife²,

Enweani³

et al. 2019

JBM

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Background: The femur is the longest and strongest tubular bone in the human body. The femoral shaft is the portion of the bone between 5 cm distal to the lesser trochanter and 6 cm proximal to the most distal point of the medial femoral condyle. Femoral shaft fractures often result from high energy forces. These fractures occur mostly among young adults. Objective: This was to determine the epidemiological pattern of closed femoral shaft fractures in a regional tertiary hospital in Enugu, Nigeria. Method: The study was a prospective study over a 12 month period (June 2015-May 2016) at National Orthopaedic Hospital, Enugu. Following ethical approval and written informed consent, patients were consecutively recruited. The patients were clinically and radiographically evaluated at presentation. The diagnosis of closed femoral shaft fractures were made from the physical examination finding of absent open wound communicating with the fracture hematoma in the thigh and anteroposterior (AP) and lateral x-rays of the affected thigh confirming the fracture pattern. The data collected included patients' demographics, the cause of injury, the side of injury and anatomic site of the injury among other parameters. The data were collected using well designed and structured proforma. Results: A total of 52 femoral shaft fractures in 50 patients were included and analyzed using SPSS version 20.0. The age range of the patients is 18-85 years with a median age of 39.1 ± 14.9 years. The most commonly affected age group is 21-30 years. There was male preponderance with a male to female ratio of 2.3:1. Majority of the fractures (76.9%) resulted from road traffic crashes most commonly following motor vehicular accident How to cite this paper: Iyidobi, E.C.,

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“…Nonetheless, because it requires no special equipment and achieves quick stabilization, some authors advocate open nailing for polytrauma patients. [ 20 23 24 ] The technique is also particularly useful in resource-poor environments because it requires less training and minimally expensive equipment. Liao et al .…”

Section: Discussionmentioning

confidence: 99%

“…[ 19 20 21 22 ] On the other hand, open reduction has the advantages of being easily learned, producing better reduction and having shorter operation times. [ 23 24 ] Kimmatker et al . also showed a significantly higher rate of rotational deformity following closed reduction of femoral shaft fractures as compared with open nailing.…”

Section: Introductionmentioning

confidence: 99%

Open intramedullary nailing for segmental long bone fractures: An effective alternative in a resource-restricted environment

et al. 2016

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Background:Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98–100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion. This study was proposed to review the outcome of management of segmental fractures with locked intramedullary nails, using an open method of reduction.Methods:A retrospective analysis was made of data obtained from all segmental long bone fractures treated with intramedullary nailing over a 1-year period. Records were retrieved from the folders of patients operated on from January 2011 to December 2011. Patients were followed up for a minimum of 1 year after the surgery.Results:We managed a total of 12 segmental long bone fractures in 11 patients. Eight of the 12 fractures were femoral fractures and 10 of the fractures were closed fractures. All but one fracture (91.7%) achieved union within 4 months with no major complications.Conclusions:Open method of locked intramedullary nailing achieves satisfactory results when used for the management of long bone fractures. The method can be used for segmental fractures of the humerus, femur, and tibia, with high union rates. This is particularly useful in low-income societies where the use of intraoperative imaging may be unavailable or unaffordable. It gives patients in such societies, a chance for comparable outcomes in terms of union rates as well as avoidance of major complications. Larger prospective studies will be necessary to conclusively validate the efficacy of this fixation method in this environment.

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Intramedullary Nailing of Femoral Shaft Fractures

Cited by 5 publications

References 0 publications

Comparative prospective study of early outcomes after osteosynthesis with locked intramedullary nailing or plating for closed femoral shaft fractures at the National Orthopaedic Hospital Enugu, Nigeria

Comparative prospective study of early outcomes after osteosynthesis with locked intramedullary nailing or plating for closed femoral shaft fractures at the National Orthopaedic Hospital Enugu, Nigeria

Epidemiological Pattern of Closed Femoral Shaft Fractures in a Regional Tertiary Hospital in Enugu, Nigeria

Open intramedullary nailing for segmental long bone fractures: An effective alternative in a resource-restricted environment

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