Retrograde reamed femoral nailing.
J Orthop Trauma
; 7(4): 293-302, 1993.
Article
em En
| MEDLINE
| ID: mdl-8377037
ABSTRACT
Closed, reamed, antegrade nailing remains the standard of care for femoral shaft fractures. This technique however, may be less attractive in the management of femoral shaft fractures associated with (a) ipsilateral acetabular, pelvis, or femoral neck fractures; (b) polytrauma requiring multiple simultaneous surgical procedures; and (c) pregnancy. We now report on our experience with the retrograde femoral nailing as a treatment option in these situations. Between 4/88 and 10/90, 29 retrograde femoral nailing in 24 patients were attempted. Average age was 29.3 (16-74) years. Five fractures were open. Fracture location was isthmal in 14 and infraisthmal in 15. The comminution was classified according to Winquist and Hansen I(10), II(7), III(7), and IV(5). Nailing was possible in 28/29 cases. Insertion was made through an extraarticular medial condylar portal. Nail diameter ranged from 10 to 13 mm. An AO Universal Femoral Nail was used in the first 11 cases; all subsequent fractures were stabilized using an AO Universal Tibial Nail because its design appeared better suited to this technique. Follow-up was possible for 25 fractures in 21 patients and averaged 16.0 (range, 11-27); months 23/25 (92%) fractures healed within 12 weeks. No case was associated with an infection, loss of reduction, or nail failure. Knee flexion averaged 122 degrees; only two knees had an extensor lag of > 5 degrees. Intraoperative complications included three cases of crack propagation at the insertion site, and four infraisthmal malreductions (two valgus, two flexion). Based on these results, we feel that retrograde reamed femoral nailing is a suitable alternative to antegrade nailing and should be considered in situations where proximal access is neither possible nor desirable.
Buscar no Google
Tema:
Complicacoes
/
Diagnostico
/
Epidemiologia
/
Geral
/
Prevencao_controle
/
Reabilitacao
Bases de dados:
MEDLINE
Assunto principal:
Ossos Pélvicos
/
Complicações na Gravidez
/
Pinos Ortopédicos
/
Traumatismo Múltiplo
/
Fraturas Ósseas
/
Fraturas do Fêmur
/
Fraturas do Colo Femoral
/
Fixação Intramedular de Fraturas
/
Acetábulo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Orthop Trauma
Ano de publicação:
1993
Tipo de documento:
Article