The treatment of femoral shaft fractures with interlocking intramedullary nailing in adults: an easy technique for distal locking

Mehmet ARAZİ; Mustafa YEL; M. OKTAR; Tunc OGUN; Recep MEMİK

Article Details

The treatment of femoral shaft fractures with interlocking intramedullary nailing in adults: an easy technique for distal locking

Authors:

Mehmet ARAZİ | Mustafa YEL | M. OKTAR | Tunc OGUN | Recep MEMİK

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 1999 Vol.33 Issue 2, pp.126-130

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813608

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Keywords:

-

Abstract:

 

We describe an easy method for distal screw insertion in locked intramedullary nailing procedure and also present the early results of the femoral shaft fractures treated using this method and interlocking nailing. Between 1995 and 1997, 35 femoral shaft fractures which were not suitable for non-interlocked nailing because of localization and comminution were treated by interlocking nailing. The fractures were located in the proximal third of femur in 12 cases, middle in 15, and distal in 8. According to the criteriae of Winquist et al., there were 9 Type I comminution, 8 Type II, 13 Type III and 5 Type IV. For distal locking an easy tecnique modified from freehand technique was used. For tracing of the proximal bone cortex a new pin holder designed to keep the surgeon from radiation was used. The average follow-up was seven months (six to 19 months). There was no nonunions and no need for bone grafting as there was no delayed unions. Two deep late infections (5.7%) were observed. After the complete union the nails were removed, thereafter the infections were cured completely. In one case, incomplete femoral neck fracture occured during the insertion of the nail. The fracture was fixed with three cannulated screws anterior and posterior to proximal part of the nail. The average screening time was 6 minutes (3 to 12 min.). The average operating time was one hour and 45min (45 min. to 4 hours). According to the Thoresen et al.’s criteriae for clinical and radiographic evaluation of the patients, excellent and good results were established in 30 (86%) patients. Conclusions: we concluded that the interlocking nailing of the femoral shaft fractures is one of the best treatment modalities with a wide application range and also using the above described method, distal screw insertion can be performed easily, as well as quickly.

 

Bu çalışmada, kilitli intramedüller çivileme ameliyatlarında distal kilitleme için gelişimleri bir tekniğin tanımlanması ve bu teknikle tedavi edilen, femur cisim kırıkların erken dönem tedavi sonuçları sunulmuştur. 1995 ve 1997 yılları arasında standart çivilemeye uygun olmayan yerleşim ve/veya parçalanma gösteren 35 hastanın femur cisim kırığı kilitli intramedüller çivileme ile tedavi edildi. Kırıkların 12'si proksimal 1/3, 15'i orta 113 ve 8'i distal 113 bölgedeydi. Winquist ve ark.nın sınıflamasına göre, 9 kırık Tip I, 8 Tip II, 13 Tip III ve 5 kırık Tip IV parçalanma gösteriyordu. Komplikasyon olarak, iki hastada geç dönemde belirginleşen derin enfeksiyon ve bir hastada ameliyat sırasında tam olmayan femur boyun kırığı tespit edildi. Ortalama takip süresi 7 aydı (6-19 ay). Hiçbir hastada kırık kaynamaması görülmezken, kaynama gecikmesi nedeniyle kemik greft uygulaması da yapılmadı. Ortalama skopi kullanma süresi 6 dakikaydı (3-12 dak.). Ortalama ameliyat süresi, 1 saat 45 dak. (45 dak.-4 saat) olarak tespit edildi. Hastaların klinik ve radyolojik değerlendirilmeleri, Thoresen ve ark. değerlendirme kriterleri kullanılarak yapıldı. Buna göre 30 hastada (%86) mükemmel ve iyi sonuç elde edildi. Sonuç olarak, kilitli intramedüller çivileme, femur cisminde oldukça geniş bir alanda başarıyla uygulanabilecek bir tedavi yaklaşımı olduğu kanaatine varıldı. Yeni tanımlanan çivi tutucu ve distal çivileme tekniği ile kilitleme işlemi daha kolay ve kısa sürede yapılabilmektedir.

Article Details

The treatment of femoral shaft fractures with interlocking intramedullary nailing in adults: an easy technique for distal locking

Authors: Mehmet ARAZİ | Mustafa YEL | M. OKTAR | Tunc OGUN | Recep MEMİK

Publisher: Turkish Association of Orthopaedics and Traumatology

Journal: Acta Orthopaedica et Traumatologica Turcica 1999 Vol.33 Issue 2, pp.126-130

Document Type: Article

Publication Date: 9/2006

Document Language: English

Document ID (Org No.): 2000813608

Frequency: Bimonthly

eISSN: 1017-995X

pISSN: 1017-995X

-

Issues

Authors:

Mehmet ARAZİ | Mustafa YEL | M. OKTAR | Tunc OGUN | Recep MEMİK

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 1999 Vol.33 Issue 2, pp.126-130

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000813608

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X