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The learning curve with a new cephalomedullary femoral nail.
Fine, N F; Sexton, S A; Williams, D H.
Afiliación
  • Fine NF; Royal Cornwall Hospital, Truro, Cornwall, UK. Electronic address: nfine@nhs.net.
  • Sexton SA; Royal Cornwall Hospital, Truro, Cornwall, UK.
  • Williams DH; Royal Cornwall Hospital, Truro, Cornwall, UK.
Injury ; 48(7): 1575-1578, 2017 Jul.
Article en En | MEDLINE | ID: mdl-28558930
INTRODUCTION: The Cephalomedullary Nail (CMN) (Zimmer, Warsaw) was introduced in 2010 as part of a multicenter trial to evaluate its performance. At one year the CMN had results in keeping with other intramedullary devices with good union rates and low complication rates. In the second and third years of use an increased rate of implant failure was observed, towards the higher end of the 1-5% nail breakage rate seen in other studies. This study aims to evaluate if there any common features in this cohort of patients. MATERIALS AND METHODS: This is a retrospective cohort study looking at patients who underwent femoral fracture fixation using the cephalomedullary nail between January 2011 and June 2014. The primary outcome measure was implant failure; secondary outcomes were; fracture reduction and bisphosphonate use. RESULTS: 201 patients were included (135 female, 66 male) with an average age of 81 years. Ten (5%) nail breakages occurred in the study period at an average of 39 weeks (24-92); 9 were 125° nails 1 was a 130° nail and all fractured at the lag screw junction. CONCLUSIONS: Implant failure is a recognised complication of intramedullary nailing in cases of non-union. The increased rate of implant failure in our department required a change to a 130° CMN implant and a 3.2mm diameter guide wire for placement of the lag screw. We continue to monitor this difficult group of patients very closely.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Clavos Ortopédicos / Fracturas del Fémur / Curva de Aprendizaje / Fijación Intramedular de Fracturas / Fracturas no Consolidadas Tipo de estudio: Observational_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Injury Año: 2017 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Clavos Ortopédicos / Fracturas del Fémur / Curva de Aprendizaje / Fijación Intramedular de Fracturas / Fracturas no Consolidadas Tipo de estudio: Observational_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Injury Año: 2017 Tipo del documento: Article