Overdistraction of the Fracture Eases Reduction in Delayed Femoral Nailing: Results of Intraoperative Force Measurements

Gösling, Thomas; Hüfner, T.; Westphal, Ralf; Faulstich, J.; Hankemeier, Stefan; Wahl, Friedrich M.; Krettek, Christian

doi:10.1097/01.ta.0000197431.05396.27

Cited by 19 publications

(13 citation statements)

References 16 publications

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“…836.000 accidents were reported in Austria in 2009 -6% in traffi c, 21% at work and school, while 73% were home,-sport-and leisure time accidents [29,30]. Due to these injuries 6.298.271 sick-leave days were registered, with every second day being caused by accidents from the fi eld of home/leisure time/sport.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological and economic aspects of polytrauma management in Austria

Aldrian

Wernhart

Negrin

et al. 2011

Wien Klin Wochenschr

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Section: Discussionmentioning

confidence: 99%

Epidemiological and economic aspects of polytrauma management in Austria

Aldrian

Wernhart

Negrin

et al. 2011

Wien Klin Wochenschr

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“…The duration of the reposition process could have imposed a limiting factor as well. Manual reposition of a femoral fracture lasts between 6 and 28 min [32], whereas the 10× reduction process in our study took 36 s.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical and histological analyses of the fracture healing process after direct or prolonged reduction

et al. 2018

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BackgroundReduction of femoral shaft fractures remains a challenging problem in orthopaedic surgery. Robot-assisted reduction might ease reduction and fracture treatment. However, the influence of different reduction pathways on patients’ physiology is not fully known yet. Therefore, the aim of this study was to examine the biomechanics and histology of fracture healing after direct and prolonged robot-assisted reduction in an in vivo rat model.Methods144 male CD® rats were randomly assigned to 12 groups. Each animal received an external fixator and an osteotomy on the left femoral shaft. On the fourth postoperative day, the 1× reduction groups received a single reduction maneuver, whereas the 10× reduction groups received the same reduction pathway with ten repetitions. The control groups did not undergo any reduction maneuvers. Animals were killed after 1, 2, 3 and 4 weeks, respectively, and the composition of the fracture gap was analyzed by µCT and non-decalcified histology. Biomechanical properties were investigated by a three-point bending test, and the bone turnover markers PINP, bCTx, OPG, sRANKL, TRACP-5b, BALP, and OT/BGP were measured.ResultsOne week after the reduction maneuver, µCT analysis showed a higher cortical bone volume in the 1× reduction group compared to the 10× reduction group. Biomechanically, the control group showed higher maximum force values measured by three-point bending test compared to both reduction groups. Furthermore, less collagen I formation was examined in the 10× reduction group compared to the control group after 1 week of fracture healing. PINP concentration was decreased in 10× reduction group after 1 week compared to control group. The same trend was seen after 3 weeks.ConclusionA single reduction maneuver has a beneficial effect in the early phase of the fracture healing process compared to repeated reduction maneuvers. In the later phase of fracture healing, no differences were found between the groups.

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“…A path from the current to the target pose of the distal fragment is then planned, taking into account the anatomical constraints. We have previously assessed the forces required to perform femur fracture reduction, as well as the forces experienced by the surrounding soft tissues and the inflammatory response to different reduction paths . The magnitude of soft‐tissue trauma in an eventual in vivo reduction could potentially be reduced by minimizing the required forces and by avoiding unnecessary movements.…”

Section: Methodsmentioning

confidence: 99%

Comparison of algorithms for automated femur fracture reduction

Suero

Westphal

Citak

et al. 2017

Robotics Computer Surgery

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Purpose: We designed an experiment to determine the comparative effectiveness of computer algorithms for performing automated long bone fracture reduction.Methods: Automated reduction of 10 3D fracture models was performed using two computer algorithms, random sample matching (RANSAM) and Z-buffering (Z-Buffer), and one of five options of post-processing: none; iterative closest point algorithm (ICP); ICP-X1; ICP-X2;and ICP-X3. We measured the final alignment between the two fragments for each algorithm and post-processing option.

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Overdistraction of the Fracture Eases Reduction in Delayed Femoral Nailing: Results of Intraoperative Force Measurements

Abstract: Fracture shortening leads to higher restraining forces and consequently prolonged reduction time in delayed nailing. Overdistraction should be performed as soon as possible under careful soft-tissue monitoring.

Cited by 19 publications

References 16 publications

Epidemiological and economic aspects of polytrauma management in Austria

Epidemiological and economic aspects of polytrauma management in Austria

Biomechanical and histological analyses of the fracture healing process after direct or prolonged reduction

Comparison of algorithms for automated femur fracture reduction

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