Surgical treatment of multifragmentary segmental femur shaft fractures with ORIF and bone graft versus MIPO: a prospective control-group study

Rollo, Giuseppe; Ronga, Mario; Bonura, Enrico Maria; Erasmo, Rocco; Bisaccia, Michele; Pichierri, Paolo; Marsilio, Antonio; Pasquino, Andrea; Gomez-Garrido, David; Franzese, Raffaele; Schiavon, Andrea; Meccariello, Luigi

doi:10.17392/1150-20

Medicinski Glasnik

2020

DOI: 10.17392/1150-20

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Surgical treatment of multifragmentary segmental femur shaft fractures with ORIF and bone graft versus MIPO: a prospective control-group study

Giuseppe Rollo

Mario Ronga

Enrico Maria Bonura

et al.

Abstract: <p><strong>Aim<br /></strong> Multifragmentary segmental femoral shaft fracture is a high energy injury frequently associated with life-threatening conditions. The aim of this study was to compare the use of bio metallic open reduction internal fixation (ORIF) (plate with allograft bone strut) with minimally invasive plate osteosynthesis (MIPO) fixation for the treatment of multi-segmental femoral shaft fracture in terms of outcomes, bone healing and comp… Show more

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Cited by 5 publications

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Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis

Long

et al. 2022

JOIO

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Background Among the surgical methods for femoral fractures, the Ortho-Bridge System (OBS) appears to heal fractures via an uncommon process. We compared its effectiveness and biomechanical aspects to those of a locking compression plate (LCP) and explained the healing process demonstrated by the OBS. Methods Eleven femoral shaft fracture cases treated with OBS between July 2017 and May 2020 were retrospectively reviewed. Clinical and radiographic data were collected during regular postoperative follow-up visits and assessed via the Harris Hip Score and Knee Society Score. We performed biomechanical experiments of OBS. We simulated different fracture conditions and selected appropriate screw holes at the fracture’s far and near segments. The OBS module was placed according to the position of LCP’s locking hole at both ends of the fracture; then, a static three-point bending test was performed. Results All patients had contralateral callus growth with secondary fracture healing. Healing time was 3–5 months with excellent hip and knee function. When the key screw distance was 22–34 mm, the OBS was significantly less stiff than the LCP (P < 0.05). The stiffness of LCP and OBS decreased significantly when the key screw distance was 49–82 mm, with the LCP being slightly stronger (P < 0.05). Conclusions Femoral shaft fracture treatment with OBS demonstrated secondary healing. When the distance between the key screws was 20–40 mm, the elasticity was higher in OBS than in LCP, possibly producing axial micro-motion to stimulate callus formation and promote fracture healing, which differ from the plate’s primary healing process.

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Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis

Long

et al. 2022

JOIO

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One‐Stage Closed Intramedullary Nailing for Delayed Femoral Fracture in Multiple Injured Patients

Yan

et al. 2022

Orthopaedic Surgery

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Objective: To tackle the challengeable dilemma of delayed femoral fracture, a technique of fixator-assisted closed reduction and intramedullary nailing at one stage was introduced herein and its clinical results were investigated.Methods: A retrospective study was conducted on delayed femoral shaft fracture between February 2008 and January 2017. The multiple injured patients aged from 18 to 60 years with delayed femoral fracture was included. All patients were treated by one-stage internal fixation technique and followed up for more than 1 year. Outcome measures including the operation time, intraoperative blood loss and limb alignment, healing time of fracture, visual analog scale (VAS), and range of knee motion were recorded and evaluated.Results: A total of 13 patients (16 sides) with a mean injury severity score (ISS) of 32.77 AE 9.98 (range, 19 to 52) participated in the investigation. The median length of time-after-fracture was 38 days (range, 21 to 110 days). The average shortening distance of the fracture ends was 35.48 AE 19.24 mm (range, 10.00 to 79.00 mm). The average surgery time was 192.19 AE 29.38 min for unilateral femoral fracture, with blood loss of 587.50 AE 232.02 ml. The postoperative discrepancy of lower limb was 3.87 AE 2.52 mm. No patient had vascular and neurologic complications due to the lengthening. All fractures healed successfully with a mean time of 2.98 AE 0.57 months. The mean VAS and maximal knee flexion were 1.63 AE 1.09 and 131.25 AE 5.32 at final follow-up, respectively. Conclusions: Our findings indicated that fixator-assisted closed reduction and intramedullary nailing at one stage is an effective treatment for delayed femoral fracture with satisfactory functional recovery.

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Management of a Complex Supracondylar Periprosthetic Femur Fracture with Intramedullary Strut Allograft and Bilateral Locking Plates

Moukarzel

Aouad

Daher

et al. 2021

Case Reports in Orthopedics

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Supracondylar periprosthetic femoral fractures occurring above total knee replacements have been considered a rare entity. However, they continue to increase in frequency with the increasing number of arthroplasties and the improvement in morbidity and mortality in the concerned patient population. The management of periprosthetic distal femoral fractures is a challenging orthopedic problem. In this brief communication, a case of 49-year-old woman with rheumatoid arthritis who sustained a low distal comminuted periprosthetic femoral fracture is presented. Her fracture was eventually managed with an intramedullary fibular strut allograft and bilateral locking plate placement reaching satisfactory healing and restoration of alignment. The primary aim of this report is to provide insight into this novel technique as a successful alternative to other standard surgical options.

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Surgical treatment of multifragmentary segmental femur shaft fractures with ORIF and bone graft versus MIPO: a prospective control-group study

Cited by 5 publications

References 5 publications

Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis

Effectiveness and Biomechanical Analysis of the Ortho-Bridge System on Femoral Fracture Healing: A Retrospective Analysis

One‐Stage Closed Intramedullary Nailing for Delayed Femoral Fracture in Multiple Injured Patients

Management of a Complex Supracondylar Periprosthetic Femur Fracture with Intramedullary Strut Allograft and Bilateral Locking Plates

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