Prone positioning for intramedullary nailing of subtrochanteric fractrures, the techniques of intraoperative fluoroscopy and reduction: A technique note

Zhao, Zhe; Song, Fei; Zhu, Jianjin; He, Dawei; Deng, Jianzhong; Ji, Xiaolin; Tang, Peifu; Pan, Yuanjiang

doi:10.1016/j.injury.2017.08.025

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…In the present study, the CDA of femoral neck was not fully achieved in the supine position and that the cutout and nonunion was more observed in the group without the use of the traction table. Surgery with the traction table, cause delay to start operation than those not used, for reasons such as the setup of the traction table, more detailed surgical cover and obtaining fracture reduction [1,8]. In elderly patients with comorbidity, prolonged anesthesia has been reported to cause complications, which increase morbidity and mortality [15].…”

Section: Discussionmentioning

confidence: 99%

“…Supine position without traction table may be preferred if patient also have cervical spine injury, ipsilateral lower extremity fracture and severe pulmonary compromise [6,7]. Previous studies have reported that intramedullary fixation of proximal femoral fractures can be performed in the lateral decubitus position and in a publication it is described for subtrochanteric fractures in the prone position [8] without a traction table. The feasibility of nailing of intertrochanteric fractures in the supine position has not been discussed previously.…”

Section: Introductionmentioning

confidence: 99%

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İntertrokanterik kırıklarda çift eksenli femoral çivilemede traksiyon masası ve traksiyonsuz supin pozisyonunun karşılaştırılması

Yörükoğlu¹,

Aydemir²,

Yücens³

et al. 2019

Pamukkale Medical Journal

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The aim of this study was to compare the traction table and supine position without traction table in double axis femoral nailing of intertrochanteric fractures in terms of reduction quality and complication rates. Material and Method: Sixty-three patients with a mean age of 68.54±16.42 (29-97) were retrospectively analyzed. 42 patients were operated without the traction table, 21 patients were operated with the traction table. Collodiaphyseal angles and Baumgartner reduction criteria were used for radiologic evaluation. The union time of the fractures, complications, and nonunion cases were assessed. Results: The restoration of collodiaphyseal angle was better in the group using the traction table, the reduction quality could not be restored well in the group without the traction table (p<0.05). The mean union time was calculated as 3.2±2.2 months in patients operated with the traction table while in patients who were operated without a traction table was calculated as 4.26±2.23 months (p>0.05). Cutout and nonunion complications were more common in the group operated without traction table. Increasing difference of the collodiaphyseal angle was found to be correlated with the complication rates and union time. Conclusion: Better reduction was achieved in the patient group that operation performed using the traction table and the complication rates were low in this group. Operation with the traction table should be the first choice for intertrochanteric fractures. The supine position without traction table may be a preferable treatment method for intertrochanteric fractures when the traction table is not available.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

İntertrokanterik kırıklarda çift eksenli femoral çivilemede traksiyon masası ve traksiyonsuz supin pozisyonunun karşılaştırılması

Yörükoğlu¹,

Aydemir²,

Yücens³

et al. 2019

Pamukkale Medical Journal

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“…Several surgical positions have been described: supine on a fracture table, supine on a flat radiolucent table, lateral decubitus position on a flat radiolucent table, and the prone position for intramedullary nailing of subtrochanteric femoral fractures [6,7]. The position is selected on the basis of the type of lesion, the classification of the lesion, the degree of involvement of other structures and soft tissues, and finally, the surgeon's experience and preference.…”

Section: Introductionmentioning

confidence: 99%

Scissor Position of the Orthopedic Table for the Resolution of Intertrochanteric and Subtrochanteric Hip Fractures

Barrientos

Brañes

Wulf

et al. 2021

Cureus

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During the surgical resolution of intertrochanteric and subtrochanteric hip fractures on an orthopedic table, a fluoroscope needs to be used in orthogonal planes. This requires that the contralateral leg does not obstruct the radioscopic view, so patients are often placed in a hemilithotomy position. This position, also called the Lloyd-Davis position, involves hip flexion, hip abduction, hip external rotation, and knee flexion. However, rare complications, such as acute leg posterior compartment syndrome, have been described.In addition, patients with severe osteoarthritis and joint stiffness or a history of total hip arthroplasty may have difficulty achieving this position, and the well leg may be at risk of injury in a hemilithotomy position. A previously described position called the "scissor position" is, in our opinion, a safer and more efficient technique for placing the well leg on the orthopedic table, using only a pillow and a self-adhesive compression bandage. This simple position allows a lateral fluoroscopic view of the injured femur without overlapping or interference from the other limb.

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Reconstruction intramedullary nailing for a failed subtrochanteric Seinsheimer type IIB fracture: a case report

et al. 2023

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IntroductionA case of subtrochanteric Seinsheimer II B fracture was retrospectively analyzed to determine the causes of failure and the possible problems with femoral reconstruction intramedullary nailing.MethodsThis study focused on a case of an elderly patient with Seinsheimer type IIB fracture treated with minimally invasive femoral reconstruction intramedullary nailing. By retrospectively analyzing the intraoperative and postoperative course, we can identify the reasons that may lead to the surgical failure in order to avoid similar problems in the future.ResultIt was observed that the nail was dislodged after surgery, and the broken end was displaced again. Through our analysis and research, we believe that non-anatomical reduction, deviation of needle insertion point, improper selection of surgical methods, mechanical and biomechanical effects, doctor–patient communication and non-die-cutting cooperation, and non-compliance with doctor's orders may be related to the success of surgery.ConclusionFemoral reconstruction intramedullary nailing is used for the treatment of subtrochanteric Seinsheimer II B fractures; however, non-anatomical reduction, choice of needle insertion point, inappropriate choice of surgical method, mechanical and biomechanical effects, doctor–patient communication and cooperation without die-cutting, and non-compliance with doctor's advice may result in surgical failure. According to the analysis of individuals, under the premise of an accurate needle entry point, minimally invasive closed reduction PFNA or open reduction of broken ends and intramedullary nail ligation for femoral reconstruction can be used in Seinsheimer type IIB fractures. It can effectively avoid the instability of reduction and the insufficiency of the biomechanics caused by osteoporosis.

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Prone positioning for intramedullary nailing of subtrochanteric fractrures, the techniques of intraoperative fluoroscopy and reduction: A technique note

Cited by 4 publications

References 19 publications

İntertrokanterik kırıklarda çift eksenli femoral çivilemede traksiyon masası ve traksiyonsuz supin pozisyonunun karşılaştırılması

İntertrokanterik kırıklarda çift eksenli femoral çivilemede traksiyon masası ve traksiyonsuz supin pozisyonunun karşılaştırılması

Scissor Position of the Orthopedic Table for the Resolution of Intertrochanteric and Subtrochanteric Hip Fractures

Reconstruction intramedullary nailing for a failed subtrochanteric Seinsheimer type IIB fracture: a case report

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