Review Systemic Effects of Femoral Nailing

Giannoudis, Peter V.; Pape, H.-C.; Cohen, A.; Krettek, Christian; Smith, R. M.

doi:10.1097/00003086-200211000-00056

Cited by 65 publications

(10 citation statements)

References 53 publications

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“…Our preferred technique is a midshaft femoral derotational osteotomy over an antegrade intramedullary nail. Though historical literature has reported the occurrence of fat embolism syndrome in the pediatric patient and deformity correction, in our practice, by utilizing the previously reported technique of femoral venting prior to reaming, we have not experienced this complication (see Figure 12) [120][121][122][123][124][125][126][127]. Another advantage of this intramedul-…”

Section: Transverse Plane Malalignmentmentioning

confidence: 90%

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Palmer

Podeszwa

Wilson

et al. 2021

JCM

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Patellofemoral instability (PFI) encompasses symptomatic patellar instability, patella subluxations, and frank dislocations. Previous studies have estimated the incidence of acute patellar dislocation at 43 per 100,000 children younger than age 16 years. The medial patellofemoral ligament (MPFL) complex is a static soft tissue constraint that stabilizes the patellofemoral joint serving as a checkrein to prevent lateral displacement. The causes of PFI are multifactorial and not attributed solely to anatomic features within the knee joint proper. Specific anatomic features to consider include patella alta, increased tibial tubercle–trochlear groove distance, genu valgum, external tibial torsion, femoral anteversion, and ligamentous laxity. The purpose of this paper is to provide a review of the evaluation of PFI in the pediatric and adolescent patient with a specific focus on the contributions of coronal and transverse plane deformities. Moreover, a framework will be provided for the incorporation of bony procedures to address these issues.

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Section: Transverse Plane Malalignmentmentioning

confidence: 90%

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Palmer

Podeszwa

Wilson

et al. 2021

JCM

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“…These authors found that nailing was not related to increased mortality or morbidity in patients with femoral fractures and concomitant thoracic injuries. In a review, Giannoudis et al [ 32 ] reported that the systemic response following intramedullary nailing included the effect of embolised fat on lung tissue and an inflammatory reaction depending on polymorphism of neutrophil receptors. They believed that the effect of embolism is related to an individual patient’s response, which in turn depends on several cofactors (lung contusion, traumatic shock, pre-existing lung disease, sepsis, tissue damage, increased coagulation and altered cell cytoskeleton).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors report a lung complication rate of 14.6% in femoral fractures but suggest further study is needed [ 44 ]. Additionally, a number of co-factors may be responsible for the effect that fat has on the lungs [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

Karadimas¹,

Papadimitriou²,

Theodoratos³

et al. 2009

Strategies in Trauma and Limb Reconstruction

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This retrospective study presents the experience gained through use of reamed femoral nails and reports results and respective complications. This study included 415 femur fractures (312 men and 101 women with a mean age of 27.8 years) that were treated from 1993 to 2004. The fractures were classified according to AO, and 74 open fractures were included and typed according to the Gustilo classification. Dynamic nailing was performed for nearly all type A fractures and static nailing for types B and C. After a mean follow-up of 1.5 years, union rate was 97.8%. The complications were: 9 non-unions, 14 delayed-unions, 4 torsional malunions, 6 limb length discrepancies (shortening) and 30 nerve pareses due to traction. Deep venous thrombosis (DVT) occurred below the knee in 4 patients, while there were recorded 3 pulmonary and 2 fat embolisms, 1 superficial and 1 deep infection. There were 28 broken screws identified postoperatively. Logistic regression analysis revealed that type B and C were associated with increased risk of complications, with respective odds ratios of 3.1 (95% CI = 1.3–7.2, P = 0.011) and 4.3 (95% CI = 1.8–10.3, P = 0.001) when compared to type A patterns. All patients returned to their activities in a mean time of 10 months. Intramedullary nailing is still the treatment of choice for femoral shaft fractures, but knowledge of potential complications and their association with certain fracture patterns is needed.

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“…This inflammatory response involves the invasion of inflammatory cells and release of cytokines, which induce pulmonary endothelial damage and acute respiratory distress syndrome. [ 45 ]…”

Section: Special Concernsmentioning

confidence: 99%

Anesthesia for bone replacement surgery

Singh

Agarwal

2012

J Anaesthesiol Clin Pharmacol

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Advances in clinical medicine, improved understanding of pathophysiology, and the extensive application of medical technology have projected hitherto high risk and poor outcome surgical procedures into the category of routine and relatively good outcome surgeries. Bone replacement surgery is one amongst these and is wrought with a multitude of perioperative complexities. An understanding of these goes a long way in assisting in the final outcome for the patient. Here we present a review of the literature covering various issues involved during the different stages of the perioperative period.

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Review Systemic Effects of Femoral Nailing

Cited by 65 publications

References 53 publications

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

Coronal and Transverse Malalignment in Pediatric Patellofemoral Instability

The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

Anesthesia for bone replacement surgery

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