• Int Orthop · Jan 2016

    Minimally invasive treatment of displaced femoral shaft fractures with a rapid reductor and intramedullary nail fixation.

    • Wei Chen, Tao Zhang, Juan Wang, Bo Liu, Zhiyong Hou, and Yingze Zhang.
    • Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, People's Republic of China. surgeonchenwei@126.com.
    • Int Orthop. 2016 Jan 1; 40 (1): 167-72.

    PurposeTraction table-based intrameduallary (IM) nail fixation is an accepted treatment method for displaced femoral shaft fractures in adults. However, some complications have been described. To avoid complications associated with the use of a traction table, a rapid reductor was invented. This study aims to assess the outcomes of displaced femoral shaft fractures treated by a novel minimally invasive technique that employs a rapid reductor to reduce fracture and facilitate IM nail fixation.MethodsBetween November 2012 and March 2013, 22 cases of displaced femoral shaft fractures were enrolled into this study. The patients included 13 males and nine females who were between 21 and 42 years old (average, 31.3 years). All the fractures were unilateral and comprised four cases of type 32-A, 13 cases of type 32-B, and five case of type 32-C according to AO/OTA classification of fracture. During the operation, the displaced femoral shaft fractures were firstly reduced by skeletal traction with the use of a rapid reductor, and the residual antero-posterior or lateral displacement were then corrected percutaneously by using a Kirschner wire or Schantz pin with a "joy stick" technique. The fracture reduction was maintained with the rapid reductor and an IM nail was inserted to fix the fracture. The operation time, reduction time, fluoroscopy time, and intra-operative blood loss were recorded. Follow-up was conducted to assess the healing of the fractures and the functional recovery of the injured limbs.ResultsAnatomical or nearly anatomical fracture reduction was achieved in all 22 cases and open reduction was not required in any case. The average operative time, fracture reduction time, fluoroscopy time and blood loss were 58 minutes (range, 43-95 minutes), 9.1 min (range, 6-15 minutes), 13.2 seconds (range, 4.5-41.0 seconds) and 87 mL (range, 60-150 mL), respectively. During the operation, no incident of reductor-induced neurovascular injury or Schantz pin-induced ilium splitting occurred. Twenty-two patients were followed up for an average of 20.3 months (range, 18-22 months). All fractures healed well on an average of six months. No limb length discrepancy was noted.ConclusionsThe rapid reductor can be applied to effectively achieve and maintain the reduction of displaced femoral shaft fractures in a minimally invasive fashion, which is conducive for IM nailing fixation. The patients exhibited excellent functional recovery.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…