Long bone fractures: treatment patterns and factors contributing to use of intramedullary nailing

Chitnis, A.S.; Ray, B.; Sparks, C.; Grebenyuk, Y.; Vanderkarr, M.; Holy, Chantal E.

doi:10.1080/17434440.2020.1779055

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…with an epidemiological study of fracture cases in the 9 Based on the literature, the incidence of fractures is most common in people of productive age. This is associated with high-intensity activities in this age group, which can increase the risk of accidents.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Interleukin-1β Levels In Open and Closed Fracture Patients of The Long Bone In Padang

Arnif

Sahputra

Maska

2021

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Background and Purpose. Trauma is a significant burden on causes of death, disability, and financing in least developed or "third world" countries. Fracture healing, especially in wounds and tissues, begins with a hemostatic and inflammatory phase triggered by inflammatory mediators such as cytokines, particularly IL-1β and TNF-. The purpose of this study was to determine the difference in levels of interleukin-1β in open and closed fractures of long bones in PadangMethod. This type of research is analytic observational with cross sectional design with primary data. The data were taken from the examination of IL-1β levels in long bone fracture patients at RSUP Dr. M. Djamil, RSKB Ropanasuro and RST Reksodiwiryo Padang for 4 months starting from March 2021 to July 2021. The sampling technique in this study used non-probability sampling with the consecutive sampling method. The analysis was carried out using the Independent sample T-Test to see the difference in mean IL-1 which would be calculated for open fractures and closed fractures of long bones.Results. The results showed that most (92.9%) of the patients were male, 50% had open fractures, and 50% closed fractures. The mean value of the patient's age was 34 years and the mean level of IL-1β was 555,951 pq/L. Most of the fracture sites in patients were tibia and fibula (35.7%) and femur (35.7%) and 28.6% were radius and ulna. The results showed that there was a significant difference in the mean levels of IL-1β in patients with open and closed fractures of long bones (p-value = 0.007)Conclusion. There are differences in the levels of interleukin-1β in open and closed fractures of long bones in Padang. This research is expected to provide consideration to support examinations in health services, in this case in fracture patients

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Section: Discussionmentioning

confidence: 99%

Comparison of Interleukin-1β Levels In Open and Closed Fracture Patients of The Long Bone In Padang

Arnif

Sahputra

Maska

2021

bsm

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“…13 A previous evaluation by our research group using commercial and Medicare supplemental data found that IMN was the most common treatment for fractures of the femur over the past four years and IMN utilization rates have been constant during that time. 14 IMN fixation can be challenging given the inherent nature of many of the patients' fractures and the health status of much of the patient population. 15 Complications of IMN reported in the literature include malalignment, cutout, infection, false drilling, wrong lag screw length, drill bit breakage, malrotation of the femoral diaphysis, elongation of the femur, impaired bone healing, periprosthetic fracture, fracture collapse, implant failure, lag screw intrapelvic migration, neurovascular injury, secondary varus deviation, pain, and refracture.…”

Section: Introductionmentioning

confidence: 99%

Intramedullary Nail Breakage and Mechanical Displacement in Patients with Proximal Femoral Fractures: A Commercial and Medicare Supplemental Claims Database Analysis

Chitnis

Ray²,

Sparks³

et al. 2021

MDER

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Objective This study evaluated the rates and patterns of intramedullary nail (IMN) breakage and mechanical displacement for proximal femur fractures and the factors associated with their occurrence. Patients and Methods Patients with subtrochanteric, intertrochanteric, or basicervical femoral neck fractures treated with IMN from 2016 to 2019 were identified from commercial and Medicare supplemental claims databases and were followed for up to two years. Kaplan–Meier analysis estimated the cumulative incidence of and patterns of breakage/mechanical displacement. Multivariable Cox regression models evaluated the factors associated with breakage/mechanical displacement. Results A total of 11,128 patients had IMN fixation for subtrochanteric, intertrochanteric, or basicervical femoral neck fractures: (mean SD) age 75.6 (16.4) years, 66.2% female, 74.3% Medicare supplemental vs 26.7% commercial insurance. Comorbidities included hypertension (62.9%), osteoporosis (27.3%), cardiac arrhythmia (23.1%), diabetes (30.7%), and chronic pulmonary disease (16.3%). Most fractures were closed (97.2%), intertrochanteric or basicervical femoral neck (80.1%), and not pathological (91.0%). The cumulative incidence of nail breakage over two years was 0.66% overall, 1.44% for combination fractures, 1.16% for subtrochanteric fractures, and 0.49% for intertrochanteric or basicervical fractures. The cumulative incidence of mechanical displacement was 0.37% overall, 0.43% for subtrochanteric fractures, 0.42% for combination fractures, and 0.36% for intertrochanteric or basicervical femoral neck fractures. Half of the breakages occurred within five months after surgery and half of the mechanical displacements occurred within 75 days. Age 50–64 (vs 75+) and subtrochanteric or pathological fracture were more commonly associated with nail breakage. Complicated hypertension was more commonly associated with mechanical displacement. Conclusion The incidence of IMN breakage and mechanical displacement in US commercial and Medicare supplemental patients with proximal femur fractures from 2016 to 2019 was low (0.66% and 0.37%, respectively up to two years). Age 50–64 (vs 75+) and subtrochanteric or pathological fracture were more commonly associated with breakage. Complicated hypertension was associated with mechanical displacement.

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“…Humeral, femoral, tibial, and ulnar/radial shaft fractures account for 1.35%, 2.20%, 6.8%, and 2.03% of all body fractures, respectively 1 . Open reduction and internal fixation is often the main treatment option 2 . However, when there is a severe trauma 3 or a severe soft tissue injury, 4 for damage control and infection prevention, it is recommended to use external fixators for temporary fixation in the early stage 5 and then change to internal fixation 6,7 or other treatments according to the patient's condition.…”

Section: Introductionmentioning

confidence: 99%

A new technology using a customized 3D printed fixator to assist fracture reduction and fixation: Technical note

Zhou

Zhang

et al. 2021

Robotics Computer Surgery

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Background Poor reduction can lead to complications such as deformity and delayed fracture healing. We introduce a 3D printed external fixator technology that can assist in fracture reduction and fixation. Methods A fractured long bone was first fixed by a temporary external fixator and then scanned with computed tomography. Three‐dimensional reconstruction of the contour and bone fragments of the affected limb was performed using Mimics software, and the fracture reduction was simulated. Subsequently, data were imported into SolidWorks software for customized external fixator design and 3D printing. Through the precise assembly of the 3D printed external fixator and external fixation pins, automatic fracture reduction. Results The patient's fractures were well reduced, firmly fixed, and the postoperative fractures healed well with no complications. Conclusion The technique we introduce not only assists in fracture reduction for temporary external fixation but can also be used as a definitive treatment for long bone fractures.

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Long bone fractures: treatment patterns and factors contributing to use of intramedullary nailing

Cited by 5 publications

References 20 publications

Comparison of Interleukin-1β Levels In Open and Closed Fracture Patients of The Long Bone In Padang

Comparison of Interleukin-1β Levels In Open and Closed Fracture Patients of The Long Bone In Padang

Intramedullary Nail Breakage and Mechanical Displacement in Patients with Proximal Femoral Fractures: A Commercial and Medicare Supplemental Claims Database Analysis

A new technology using a customized 3D printed fixator to assist fracture reduction and fixation: Technical note

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