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International Orthopaedics

, Volume 43, Issue 6, pp 1545–1545 | Cite as

Reply to “Letter to the Editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”

  • Giovanni Vicenti
  • Massimiliano CarrozzoEmail author
  • Davide Bizzoca
  • Biagio Moretti
Letter to the Editor
  • 207 Downloads

We read with great interest and appreciate the comments by Shih-Jie Lin et al. “Letter to the editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study” in the January 2019 edition of International Orthopaedics [1].

Nonetheless, we would like to clarify the following points. With reference to the potential bias due to the inter-observer variability, it is important to remark that all the measurements were performed in the true-AP view x-rays (incorrect x-rays were excluded from our study) [2]. Moreover, it should be noted that also in the previous studies [3, 4, 5], x-rays were used to assess the third fragment features. However, we are already working on a CT-based protocol, in order to obtain a more accurate prognostic algorithm.

Finally, we reported the third fragment size, defined as the length of the major axis of the fragment [2], rather than the fragment width in the manuscript data, since the logistic regression showed that the fragment size has a critical role on the fracture healing time.

Notes

References

  1. 1.
    Lin S-J, Liaw K, Huang T-W (2019) Letter to the Editor on “The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”. Int Orthop:1–2.  https://doi.org/10.1007/s00264-019-04293-2
  2. 2.
    Vicenti G, Carrozzo M, Caiaffa V et al (2019) The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study. Int Orthop 43:193–200.  https://doi.org/10.1007/s00264-018-4214-2 CrossRefGoogle Scholar
  3. 3.
    An K-C, Kim Y-J, Choi J-S et al (2012) The fate of butterfly fragments in extremity shaft comminuted fractures treated with closed interlocking intramedullary nailing. J Korean Fract Soc 25:46.  https://doi.org/10.12671/jkfs.2012.25.1.46 CrossRefGoogle Scholar
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    Lee JR, Kim H-J, Lee K-B (2016) Effects of third fragment size and displacement on non-union of femoral shaft fractures after locking for intramedullary nailing. Orthop Traumatol Surg Res 102:175–181.  https://doi.org/10.1016/j.otsr.2015.11.014 CrossRefGoogle Scholar
  5. 5.
    Lin S-J, Chen C-L, Peng K-T, Hsu W-H (2014) Effect of fragmentary displacement and morphology in the treatment of comminuted femoral shaft fractures with an intramedullary nail. Injury 45:752–756.  https://doi.org/10.1016/j.injury.2013.10.015 CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Orthopaedic and Trauma Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of MedicineUniversity of Bari “Aldo Moro”—AOU Consorziale “Policlinico”BariItaly

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