Techniques of Obtaining and Maintaining Reduction During Nailing of Femur Fractures

Riehl, John T.; Widmaier, James C.

doi:10.3928/01477447-20090624-17

Cited by 32 publications

(23 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to US evaluations, median AV angle difference between injured and uninjured sides was found to be 5.00±2.97 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13) in group 1 and 5.00±3.34 (0-17) in group 2 (p=0.690). There was no statistically significant difference between AV angles of injured and uninjured sides of the patients in both groups ( Table 1) (p>0.05).…”

Section: Resultsmentioning

confidence: 91%

“…Unlike previous open techniques, IMN does not rely upon direct visualization of the fracture site and anatomical reduction; therefore, correct limb length, frontal and sagittal alignment and rotation are more difficult to determine [11]. One of the major concerns of IMN is the difficulty in obtaining true rotational alignment while interlocking the system [1,2,10]. Intra-operative detection of rotational malalignment is crucial to avoid malrotation.…”

Section: Discussionmentioning

confidence: 99%

“…Especially in comminuted fractures, intra-operative determination of rotational alignment and interlocking the nail in an appropriate rotational alignment is a major problem. Frequency of rotational malalignment or malrotation compared to the unaffected side after femur fractures treated with IMN is not rare [1][2][3][4]. Strecker et al have defined physiologic torsional tolerance of lower extremity as 15° [5].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Çiftdemir

Tuncel

Özcan

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Çiftdemir

Tuncel

Özcan

et al. 2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Sterile tourniquet and either a commercially or home-made 'F-tool' are examples of two closed reduction techniques which apply the mechanical principle of levers to align the fragments of the femoral fracture. [12] Accordingly, our measurement system includes two independent components, the 'F-arm' (Figure 2b) for reduction of the fracture fragments along the Y-axis and 'handgrip' (Figure 2c) for reduction of the fracture along the X-axis. The integrated system 'F-arm' includes the following components: a lever providing repositioning forces; two tension/pressure sensors transmitting voltage analog signals of the applied forces; and a flexible bracket to hold the distal fragment of the fracture fragment.…”

Section: Apparatus For Intraoperative Measurementmentioning

confidence: 99%

“…The handgrip, which consists of a header, a pressure sensor and a handle, is positioned with one of its limb on either side of the fracture, with repositioning of the fragments completed by moving the handle to reduce the displacement. [12] The F-arm measures the force applied along the Y-axis and the torque around the X-axis, Mx. Use of the two 'handgrips' allows the surgeon to apply force along the X-axis and the torque around the Y-axis, My, to correct the rotational alignment of the fracture.…”

Section: Apparatus For Intraoperative Measurementmentioning

confidence: 99%

Force–torque intraoperative measurements for femoral shaft fracture reduction

Zhu

Liang

Wang

et al. 2016

Computer Assisted Surgery

View full text Add to dashboard Cite

Background: The minimally invasive technique of closed intramedullary (IM) nailing fixation is currently considered the standard of treatment for the operative management of displaced traumatic fractures of the femur, with fracture reduction and repositioning being the first and most important step of the procedure. Skeletal-muscle traction and alignment of the fracture fragments are always performed as individual components of the reduction and repositioning phase of the procedure. Methods: As use of high traction force and repositioning forces and torques can cause additional soft tissue injury, we developed a sensor-based system to monitor these forces and torques during the treatment of diaphyseal fractures of the femur, including the monitoring of traction forces during the entire procedure, from reduction to IM nail implantation and fixation. Results: Based on a local coordinate system localized at the center of the fracture, maximum forces of 203 N along the medial-lateral (X) axis, 517 N along the anterior-posterior (Y) axis and 505 N along the shaft of the femur (Z-axis) were identified, with maximum torques of 16.4 Nm calculated around Y-axis and 38.3 Nm around X-axis. The pressure between the counteraction post and the perineum was also recorded, with magnitudes as high as 523 N being recorded. Excessive forces were identified and the difference in force-torque magnitudes during different stages of the reduction and fixation procedure were calculated. Conclusion: The measurement system provides surgeons with real-time information which can assist them in performing effective repositioning of fracture fragments within safe margins of applied forces and torques.

show abstract

How much of the superolateral femoral neck should be removed in intramedullary nail fixation for intertrochanteric fracture?

Li,

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

PurposeThe objective of this study was to measure how much of the superolateral femoral neck should be removed to reduce the incidence of wedge effect.MethodsSimulating Surgery: Computed Tomography images of 131 intertrochanteric fracture patients were included, three‐dimensionally reconstructed, virtually reduced and implanted with PFNA‐Ⅱ nail. The antero‐posterior length and media‐lateral width of the intersection between superolateral femoral neck and PFNA‐Ⅱ nail were measured. Retrospective study: The pre‐ and post‐operative CT of 30 patients were collected. The average varus angle of the neck‐shaft angle and the correlation between the angles and the difference in the actual and estimated width of the fragments removed were measured.ResultsModels of 108 patient were selected for analysis. The average antero‐posterior length and media‐lateral width were 14.46mm (14.00mm‐14.93mm) and 9.33mm (8.79mm‐9.87mm) respectively. The AO/OTA classification was not significantly associated with the outcome, but the gender was. In the retrospective study, the mean value of the varus angles was ‐4.58° (SE=6.85°), and the difference of width was strongly positively correlated with the varus angle with a correlation coefficient of 0.698.ConclusionsResults obtained in this study can improve the understanding of this region and help surgeons to make appropriate pre‐operative planning to reduce the incidence of wedge effect. Retrospective study provided effective proof of the reliability of this study.This article is protected by copyright. All rights reserved.

show abstract

Techniques of Obtaining and Maintaining Reduction During Nailing of Femur Fractures

Cited by 32 publications

References 37 publications

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing?

Force–torque intraoperative measurements for femoral shaft fracture reduction

How much of the superolateral femoral neck should be removed in intramedullary nail fixation for intertrochanteric fracture?

Contact Info

Product

Resources

About