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https://www.readbyqxmd.com/read/28399048/pediatric-femoral-shaft-fractures-a-multicenter-review-of-the-aaos-clinical-practice-guidelines-before-and-after-2009
#1
John D Roaten, Derek M Kelly, Joseph L Yellin, John M Flynn, Micaela Cyr, Sumeet Garg, Alexander Broom, Lindsay M Andras, Jeffrey R Sawyer
BACKGROUND: To determine if the AAOS clinical practice guidelines (CPG) for the treatment of pediatric femoral shaft fractures (2009) changed treatment, we analyzed pediatric femoral shaft fractures at 4 high-volume, geographically separated, level-1 pediatric trauma centers over a 10-year period (2004 to 2013). METHODS: Consecutive series of pediatric femoral shaft fractures (ages, birth to 18 y) treated at the 4 centers were reviewed. Treatment methods were analyzed by age and treatment method for each center and in aggregate...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28291432/comparison-of-non-compression-and-compression-interlocking-intramedullary-nailing-in-rabbit-femoral-shaft-osteotomy-model
#2
Mehmet Emre Baki, Cengiz Aldemir, Fatih Duygun, Ali Doğan, Gökçen Kerimoğlu
OBJECTIVES: This study aims to compare non-compression and compression intramedullary nailing in an experimental femoral shaft osteotomy model in terms of radiological, histological, and biomechanical aspects. MATERIALS AND METHODS: Twenty-four white New Zealand rabbits (average weight 4.3 kg; range 4 to 4.8 kg) were divided into three groups. A right femoral osteotomy was performed in all rabbits and all femurs were fixed with titanium compression interlocking intramedullary nail...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28229355/femoral-shaft-osteotomy-for-obligate-outward-rotation-due-to-scfe
#3
Peter M Stevens, Lucas Anderson, Bruce A MacWilliams
Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement...
April 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28202370/to-evaluate-the-role-of-platelet-rich-plasma-in-healing-of-acute-diaphyseal-fractures-of-the-femur
#4
Roop Singh, Rajesh Rohilla, Jeetesh Gawande, Paramjit Kumar Sehgal
PURPOSE: New research is focusing on the use of autologous growth factors to increase the effect of bone fracture healing while decreasing the amount of healing time for the patient. Platelets have been demonstrated to be the natural storage vessel for several growth factors and cytokines that promote blood coagulation, tissue repair, and the process of bone mineralization. The present study aims to evaluate the role of platelet-rich plasma (PRP) in healing of acute femoral shaft fractures radiologically...
February 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28186871/augmentation-of-proximal-femoral-nail-in-unstable-trochanteric-fractures
#5
Wasudeo M Gadegone, Bhaskaran Shivashankar, Vijayanad Lokhande, Yogesh Salphale
INTRODUCTION: Biomechanically proximal femoral nail (PFN) is a better choice of implant, still it is associated with screw breakage, cut out of screw through femoral head, Z effect, reverse Z effect, and lateral migration of screws. The purpose of this study is to evaluate the results of augmented PFN in terms of prevention of postoperative complications and failure rates in unstable trochanteric fractures. MATERIAL AND METHODS: We carried out a prospective study of 82 cases with unstable trochanteric femoral fractures from April 2010 to December 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28153480/radiographic-predictors-of-symptomatic-screw-removal-after-retrograde-femoral-nail-insertion
#6
Max Hamaker, Nathan N O'Hara, W Andrew Eglseder, Marcus F Sciadini, Jason W Nascone, Robert V O'Toole
INTRODUCTION: Removal of symptomatic implants is a common procedure performed by orthopaedic trauma surgeons. No guidance is available regarding which factors contribute to the likelihood of an implant becoming symptomatic. Our objective was to determine whether radiographic parameters associated with distal interlocks in retrograde femoral nails are associated with the rate of symptomatic screw removal. PATIENTS AND METHODS: We conducted a retrospective review at a Level I trauma center...
January 6, 2017: Injury
https://www.readbyqxmd.com/read/28043310/electromagnetic-navigation-in-distal-locking-of-long-diaphyseal-interlocking-intramedullary-nailing
#7
Zhentao Zhou, Xiaozhong Zhou, Bingchen Shan, Haibin Zhou, Zhengfeng Lu, Qirong Dong
OBJECTIVE: To describe the applications and effects of electromagnetic navigation (EN) technology in distal locking for the treatment of long diaphyseal fracture (LDF) with interlocking intramedullary nailing (IIN). STUDY DESIGN: An interventional study. PLACE AND DURATION OF STUDY: The Second Affiliated Hospital of Soochow University, China, from March 2013 to July 2014. METHODOLOGY: Patients who underwent IIN-LDF were selected...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27812727/-atypical-subtrochanteric-femur-fracture-under-alendronate-therapy-in-spite-of-an-intramedullar-implant
#8
H-P Sobotta, T Gösling
There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma.The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.
November 3, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27575039/nail-dynamization-for-delayed-union-and-nonunion-in-femur-and-tibia-fractures
#9
Josh Vaughn, Heather Gotha, Eric Cohen, Amanda J Fantry, Ross J Feller, Jake Van Meter, Roman Hayda, Christopher T Born
Femoral and tibial shaft fractures are common injuries in the United States. Since their introduction, reamed intramedullary nails have become the treatment of choice for most of these fractures. However, delayed union and nonunion can complicate treatment in up to 10% of patients. Removal of interlocking screws, or dynamization, can promote fracture healing in cases of delayed union or nonunion. The efficacy of nail dynamization has been reported to range from 19% to 82%. This study was conducted to evaluate the efficacy of dynamization, identify the factors associated with its success or failure, and analyze the cost compared with exchange nailing...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27536645/rupture-of-the-deep-femoral-artery-during-proximal-femoral-nailing-following-an-intertrochanteric-fracture-a-case-report
#10
Han Kook Yoon, Hyun Cheol Oh, Junyoung Park, Choidog Oyunbat, Taehwan Kim
Recently, we experienced a case where the diagnosis and management of a deep femoral artery rupture was delayed. This vascular complication occurred during the insertion of a distal interlocking screw of a proximal femoral nail for the fixation of an intertrochanteric femur fracture. A 79-year-old male patient was diagnosed with a right intertrochanteric fracture after a fall. We fixed the fracture with a proximal femoral nail (Zimmer® Natural Nail™ System). One day after the procedure, the patient complained of pain and swelling on the anteromedial side of his middle thigh followed by hypotension, anemia and prolonged thigh swelling...
March 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/27439956/retrograde-entry-portal-for-femoral-interlocking-nailing-in-femoral-nonunion-after-plate-failure-a-prospective-comparative-study-with-antergrade-portal
#11
Yasser Assaghir
The piriformis fossa is the ideal portal of entry for antegrade interlocking nailing. Localizing this portal can be difficult and its eccentricity leads to complications. This prospective comparative study was designed to compare an innovative way to obtain the ideal portal from inside the medullary canal in cases of plate failure and compare it to the classic antegrade portal. It included 41 cases (19 antegrade and 22 retrograde). The retrograde portal was significantly better in terms of entry time, radiation time, blood-loss, and wound length...
March 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27430175/treatment-for-trochanteric-fracture-of-the-femur-with-short-femoral-nail-a-comparison-between-the-asian-intramedullary-hip-screw-imhs-and-the-conventional-imhs
#12
COMPARATIVE STUDY
Hidemi Kawaji, Takuya Uematsu, Ryosuke Oba, Yoshihiko Satake, Naoya Hoshikawa, Shinro Takai
INTRODUCTION: We usually use short femoral nails for the treatment of trochanteric fracture of the femur. In this retrospective study, we investigated and compared the clinical results of the conventional intramedullary hip screw (IMHS) and the Asian IMHS, which is a redesigned version of the former. MATERIALS AND METHODS: The subjects were 42 patients; 21 treated with the Asian IMHS and 21 were treated with the conventional IMHS. From the clinical records, we retrospectively investigated the patients' age, sex, in-hospital waiting period for operation, operating time, intraoperative blood loss, walking ability before fracture and at discharge, and complication pertaining to the operation...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27408496/plate-augmentation-with-retention-of-intramedullary-nail-is-effective-for-resistant-femoral-shaft-non-union
#13
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
OBJECTIVE: Non-union after intramedullary nail fixation of femur shaft fractures is although infrequent but a challenging condition to treat. The treatment options available to deal with such a situation include exchange nailing, removal of nail and re-osteosynthesis with plating, or Ilizarov fixation. We believe that rotational instability, in the presence of a nail, is one of the main reasons for most of the non-union. We present our experience of plate augmentation leaving the nail in situ for non-union of femoral shaft fracture...
December 2016: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27391773/early-clinical-experience-with-a-newly-designed-interlocking-nail-system-targon-%C3%A2-vet
#14
Michael Brückner, Martin Unger, Markus Spies
OBJECTIVE: To describe early clinical experience with a newly designed interlocking nail system (Targon(®) Vet) in diaphyseal fractures in cats and small dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned cats (n=49) and dogs (n=8). METHODS: Fifty-seven consecutive cases (49 cats, 8 dogs) with 60 long bone fractures were included in the study. Follow-up radiographs were scheduled at 4 and 8 weeks and again 6 months postoperatively...
August 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27369636/biomechanical-effects-of-morphological-variations-of-the-cortical-wall-at-the-bone-cement-interface
#15
Chun-Lin Zhang, Guo-Qi Shen, Kun-Peng Zhu, Dong-Xu Liu
BACKGROUND: The integrity of bone-cement interface is very important for the stabilization and long-term sustain of cemented prosthesis. Variations in the bone-cement interface morphology may affect the mechanical response of the shape-closed interlock. METHODS: Self-developed new reamer was used to process fresh pig reamed femoral canal, creating cortical grooves in the canal wall of experimental group. The biomechanical effects of varying the morphology with grooves of the bone-cement interface were investigated using finite element analysis (FEA) and validated using companion experimental data...
July 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27318670/percutaneous-rotational-osteotomy-of-the-femur-utilizing-an-intramedullary-rod
#16
Peter M Stevens, Christian J Gaffney, Heather Fillerup
The purpose is to describe the technique and report the results and complications of percutaneous femoral rotational osteotomy, secured with a trochanteric-entry, locked intramedullary rod, in adolescents with femoral anteversion. Our series comprised an IRB approved, retrospective, consecutive series of 85 osteotomies (57 patients), followed to implant removal. The average age at surgery was 13.3 years (range 8.8-18.3) with a female-to-male ratio of 2.8:1. The minimum follow-up was 2 years. Eighty-three osteotomies healed primarily...
August 2016: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/27299059/soft-tissue-swelling-associated-with-the-use-of-recombinant-human-bone-morphogenetic-protein-2-in-long-bone-non-unions
#17
Andrew Young, Adam Mirarchi
This report describes two cases of long bone non-union associated with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) and is the first of its kind. The first case describes a 25-year-old male who sustained a left diaphyseal femoral shaft fracture initially treated with operative fixation using an intramedullary nail, which subsequently loosened distally and was treated with exchange nailing and rhBMP-2 application. This patient developed acute local soft tissue inflammation post-operatively...
July 2015: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27234421/interlocking-intramedullary-nail-fixation-with-additional-bone-grafting-from-trochanter-via-a-femoral-hollow-trephine-in-the-treatment-of-femoral-shaft-fractures-design-and-clinical-application
#18
Yinwen Liu, Yuxin Zheng, Ziliang Shen, Shuqiang Wang, Xiaoen Wei, Xinfeng Gu, Hongsheng Zhan, Yong Kuang
PURPOSE: The purpose of this study was to describe and evaluate the clinical application of the technique of interlocking intramedullary (IM) nailing via an entry point at the tip of greater trochanter using a specially designed femoral hollow trephine to stabilize diaphyseal fractures of the femur. METHODS: From February 2010 to April 2014, 35 consecutive patients with femoral shaft fractures were treated by the therapy of bone grafting from trochanter region with interlocking IM nail...
February 2017: International Orthopaedics
https://www.readbyqxmd.com/read/27140219/surgical-factors-contributing-to-nonunion-in-femoral-shaft-fracture-following-intramedullary-nailing
#19
Yong-Gang Ma, Ge-Liang Hu, Wei Hu, Fan Liang
PURPOSE: To explore the possible surgical factors related with nonunion in femoral shaft fracture following intramedullary nailing. METHODS: We retrospectively analyzed totally 425 patients with femoral shaft fracture in level I urban trauma center, including 254 males and 171 females, with an average age of 37.6 (ranging from 21 to 56) years old. The inclusion criteria included: (1) traumatically closed fracture of femoral shaft, with pre- operative films showing non-comminuted fracture, such as transverse fracture, oblique fracture or spiral fracture; (2) closed reduction and fixation with interlocking intramedullary nail at 3-7 days after trauma; (3) complete follow-up data available...
April 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27129382/removal-torque-of-nail-interlocking-screws-is-related-to-screw-proximity-to-the-fracture-and-screw-breakage
#20
Alexander A White, Meghan R Kubacki, Jason Samona, Paul Telehowski, Patrick J Atkinson
Studies have shown that titanium implants can be challenging to explant due to the material's excellent biocompatibility and resulting osseointegration. Clinically, titanium alloy nail interlocking screws may require removal to dynamize a construct or revise the nail due to nonunion, infection, pain, or periprosthetic fracture. This study was designed to determine what variables influence the removal torque for titanium alloy interlocking screws. An intramedullary nail with four interlocking screws was used to stabilize a 1-cm segmental femoral defect in a canine model for 16 weeks...
June 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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