RESUMO
BACKGROUND: This study aims to determine whether nail size or the difference between canal and nail diameter (CN difference) affects the union rate and time of femoral shaft fracture treated with an interlocking intramedullary nail (IMN). METHODS: This was a retrospective review of 257 patients with femoral shaft fractures treated with IMN at a tertiary trauma medical center. All the IMN inserted were the same (Stryker T2 Femoral Nail). The patients were divided into groups based on nail size (10-, 11-, 12-, or 13-mm) and CN difference (< 1, 1-2, or > 2 mm), and union rate and time to union were compared. RESULTS: The 10-, 11-, 12-, and 13-mm groups based on nail size had 113, 74, 54, and 16 patients, respectively. The overall union rate was 97% (257/265). No significant differences in union rate or time to union were observed among these 4 groups. The groups based on CN differences of < 1-, 1 to 2, and > 2 mm comprised 143, 79, and 35 patients, respectively. Again, no significant differences were noted in union rate or mean time to union among the groups. CONCLUSIONS: Similar union rate and time to union were observed, regardless of nail size or CN difference. This finding indicates that most simple femoral shaft fractures can be treated with a standard, reamed 10-mm IMN. A larger nail insertion is unnecessary and presents more risks; comparatively, the use of a small nail with less reaming is simpler, requires shorter operative times, results in less blood loss, and is less expensive.
Assuntos
Fraturas do Fêmur , Fixação Intramedular de Fraturas , Fraturas não Consolidadas , Pinos Ortopédicos , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/etiologia , Fraturas do Fêmur/cirurgia , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/métodos , Consolidação da Fratura , Fraturas não Consolidadas/cirurgia , Humanos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Pasteurella multocida is a small facultative anaerobic Gram-negative coccobacillus. Bites or scratches from cats or dogs are common transmission route causing zoonotic infections in humans. The pathogen rarely cause prosthetic joint infection. We report the first case, to our knowledge, of a prosthetic joint infection in a patient underwent liver transplantation caused by this pathogen. Pasteurella multocida is a high pace growing pathogen. Physician should raise awareness with related history especially in patients with immunosuppressive status. Management with the proper antibiotics administration in conjunction with timely surgical intervention could prevent devastating complications and preserve the artificial joint.