Resultados do tratamento das fraturas da diáfise do fêmur ipsilaterais às do colo ou transtrocantérica

Neto, Nelson Astur; Lins, Romero Antunes Barreto; Kojima, Kodi Edson; Cunha, Bruno Leme da; Neto, José Soares Hungria; Mercadante, Marcelo Tomanik; Christian, Ralph Walter; Hungria, José Octávio Soares

doi:10.1590/s1413-78522010000500004

Cited by 5 publications

(5 citation statements)

References 16 publications

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“… N.A. Neto et al (2010) [ 52 ] August 2002 and October 2007 17 (17) 15 (88%) 33 (19–47) 17 (100%) FN + TF 1 (6%) 8 9 N.A. N.A.…”

Section: Resultsmentioning

confidence: 99%

“…Nonunion of the femur neck was noted in 6.4% (95% CI 3.9–9.4%) when treated with a single implant and in 8.2% (95% CI 5.3–11.6%) when treated with a separate device for each fracture [ 3 – 5 , 7 – 9 , 12 , 18 , 21 , 25 , 26 , 28 , 32 , 33 , 43 , 45 – 50 , 55 , 56 , 61 ]. Varus malunion was noted in 6.6% of the patients in the single implant group (95% CI 3.9–10.1%) and in 10.9% in the double implant group (95% CI 6.6–16.2%) [ 3 – 5 , 7 , 9 , 21 , 24 – 27 , 38 , 41 , 42 , 44 , 46 , 49 , 52 , 55 , 57 , 61 , 63 ]. The pooled rates were higher for the double implant group but the overlapping confidence intervals suggest that nonunion and varus malunion of the femur neck are unrelated to the number of implants used.…”

Section: Resultsmentioning

confidence: 99%

“…The overlap in 95% confidence intervals does not suggest a superior treatment. In all bone healing-related complications, treatment with a single implant showed 1.6–2.7-fold higher pooled rates compared to patients treated with double implants, which is, respectively, 19.9% (95% CI 9.3–33.3%) in single implants versus 10.8% (95% CI 7.1–15.4%) in double implants for delayed union [ 4 , 6 , 7 , 9 , 21 , 27 , 38 , 46 , 49 , 52 , 53 , 56 , 61 , 62 , 64 ]. Nonunion was seen in 17.3% (95% CI 11.1–24.6%) in single implant versus 14.2% (95% CI 8.8–20.7%) in double implants [ 4 , 5 , 9 , 12 , 18 , 20 , 21 , 23 – 25 , 27 , 29 , 33 , 34 , 39 , 43 – 45 , 47 , 50 , 53 – 58 , 60 , 61 , 63 ].…”

Section: Resultsmentioning

confidence: 99%

“…Nonunion was seen in 17.3% (95% CI 11.1–24.6%) in single implant versus 14.2% (95% CI 8.8–20.7%) in double implants [ 4 , 5 , 9 , 12 , 18 , 20 , 21 , 23 – 25 , 27 , 29 , 33 , 34 , 39 , 43 – 45 , 47 , 50 , 53 – 58 , 60 , 61 , 63 ]. Malunion was seen in 17.5% (95% CI 4.9–35.7%) when treated with a single implant versus 6.4% (95% CI 1.3–15.0%) in patients treated with double implants [ 9 , 20 , 25 , 26 , 52 , 57 ]. However, the overlapping confidence intervals showed no convincing evidence of a statistical difference between the two groups.…”

Section: Resultsmentioning

confidence: 99%

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Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Lieshout

Verhofstad

2023

Arch Orthop Trauma Surg

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Introduction Fractures of the proximal femur accompanied by a fracture of the femoral shaft are relatively rare, with a reported prevalence between 1 and 12%. Multiple surgical options are available, consisting of treatment with a single implant or with double implants. Controversy exists about the optimal management. A systematic review and pooled analysis were performed to assess the most reliable treatment for bifocal femoral fractures of the femur. Materials and methods A literature search was conducted on July 15, 2022. Selected studies were screened on title and abstract by two researchers independently, and full texts were read by both authors. Emphasis was put on adverse events such as postoperative infection, healing complications, malalignment, and functional outcome using either a single implant or double implants. Results For the proximal femoral fractures, no significant difference could be confirmed for avascular necrosis of the femoral neck (5.1% for single implant and 3.8% for double implants), nonunion (6.4% for single implant and 7.8% for double implants), or varus malalignment (6.6% for single implant and 10.9% for double implants). This study also suggests that the number of implants is irrelevant for complications of the femoral shaft regarding the rates of postoperative infection and healing complications. Pooled rates of bone healing complications were 1.6–2.7-fold higher when patients were treated with a single implant, but statistical significance could not be confirmed. For hardware failure, revision surgery, leg length discrepancy, and functional outcome, no difference between the two groups was found either. Conclusions The pooled proportions of all postoperative complications had overlapping confidence intervals; thus, no inference about a statistically significant difference on the number of implants used for treating ipsilateral fractures of the femur can be made. Both treatment groups showed a similar functional outcome at the last moment of follow-up, with more than 75% of the patients reporting a good outcome.

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“… N.A. Neto et al (2010) [ 52 ] August 2002 and October 2007 17 (17) 15 (88%) 33 (19–47) 17 (100%) FN + TF 1 (6%) 8 9 N.A. N.A.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Lieshout

Verhofstad

2023

Arch Orthop Trauma Surg

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“…However, we could not ascertain this rise, when comparing our findings with those of Alho of the 20 th century [3,4]. [26,27,29,[32][33][34][35][36]40,44,45,[47][48][49][53][54][55][56]58,61,63,[65][66][67][68][69]72,73,76,77,79,80,[83][84][85]87,[90][91][92]94,96,98,100,109,110] and the present series 18.3 (16.2) Grades of Open Femoral Shaft Fractures (Gustilo) 26 [32,34,40,…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Diagnosis of Ipsilateral Femoral Neck and Shaft Fractures: A Systematic Review of 1761 cases in 1758 Patients (I.1990-VI.2015)

Barquet¹

2015

Trauma Cases Rev

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Objectives: Ipsilateral femoral neck and shaft fractures [IFNSF] are uncommon. The existing literature is characterized by a diversity of small reports with a lack of consensus. We performed a systematic review to examine the epidemiology and diagnosis of this injury.Methods: Nineteen databases were used to find articles published between January 1990 and June 2015 with no language restriction. Inclusion criteria were studies describing a minimum of five patients 16 years old or older with acute IFNSF and adequate extractable data. Exclusion criteria were trochanteric fracture and malignancy at the time of retrieval. A series from the senior authors was also included. Results:The selected 85 studies together with our series produced a total of 1758 patients with 1761 cases. The frequency of IFNSF in all femoral shaft fractures was 3, 37%, mostly resulting from high energy trauma. The typical patient was a young adult male; the mean frequency of multiple injuries was 73.5 and ipsilateral knee injuries it was 27.3. Most neck fractures originated at the base of the neck, and the mean frequency of variable cranial exit point was 6 for sub capital, 35.5 for midcervical and 58.3 for basicervical. The mean proportion of vertical shear fractures was 60. The mean frequency of undisplaced neck fractures was 57.4. Shaft fractures were most often in the middle third -mean 74.4-and they were open in a mean of 18.3. The neck fracture was diagnosed postoperatively in a mean proportion of 8.7 of the cases. Diagnosis of the femoral neck fracture using only X-rays in the period 1990-2000 failed to demonstrate the fracture in 14% of the cases; a more careful scrutiny of the radiographs and other views improved diagnosis leaving 7.88% of the cases without diagnosis in the period 2001-2015. The use of radiographs and CT scans and a protocol of radiographs, CT scans and intraoperative fluoroscopy reduced misdiagnosis to 4.94% and 6.34%, respectively. Conclusions:This systematic review describes epidemiology of IFNSF, characterizes the usual pathoanatomy of the injuries and shows the influence of imaging protocols in improving diagnosis.

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The locomotor system as seen in Brazilian medical journals: a restricted collection of papers

Patel¹,

Caramelli²,

Silva³

2011

Revista da Associação Médica Brasileira

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Resultados do tratamento das fraturas da diáfise do fêmur ipsilaterais às do colo ou transtrocantérica

Cited by 5 publications

References 16 publications

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Epidemiology and Diagnosis of Ipsilateral Femoral Neck and Shaft Fractures: A Systematic Review of 1761 cases in 1758 Patients (I.1990-VI.2015)

The locomotor system as seen in Brazilian medical journals: a restricted collection of papers

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