Skip to main content

Advertisement

SpringerLink
Log in

Displaced femoral shaft fractures treated by antegrade nailing with the assistance of an intramedullary reduction device

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

This study aims to assess the outcomes of displaced femoral shaft fractures (DFSFs) treated by antegrade nailing with the assistance of a newly invented intramedullary (IM) reduction device.

Methods

From December 2012 to August 2013, 43 adult patients with unilateral DFSFs, including 31 males and 12 females, were enrolled into this study. During the operation, the device was used to adjust the direction of guide wire to insert it into the medullary cavity of distal femur and used as a “joystick” to align the femoral shaft fractures before the insertion of IM nail. The operative time and fluoroscopy time were recorded. Follow-up was conducted to assess the fracture union and functional recovery of the affected limbs.

Results

The IM reduction device was used intra-operatively to advance the guide wire into the distal femoral medullary cavity successfully in all 43 cases, with a single attempt in 37 cases and two or three attempts in six cases. The average operative time and fluoroscopy time were 58.3 minutes (40–85 minutes) and 9.2 seconds (4.1-21.8 seconds), respectively. All fractures healed well on an average of 5.4 months post-operatively. No limb-length discrepancy or observable malalignment was noted at the follow ups.

Conclusions

The IM reduction device can facilitate the insertion of a guide wire into the distal femoral medullary cavity in a closed and controllable manner, be used as a “joystick” to align the femoral shaft fracture, and subsequently facilitate IM nail insertion in the proper position.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Zhang Y (2014) Clinical Epidemiology of Orthopedic Trauma, 2nd edn. People’s Medical Publishing House, Beijing

    Google Scholar 

  2. Chen W, Zhang T, Wang J, Liu B, Hou Z, Zhang Y (2015) Minimally invasive treatment of displaced femoral shaft fractures with a rapid reductor and intramedullary nail fixation. Int Orthop [Epub ahead of print]. doi:10.1007/s00264-015-2829-0

  3. Yang KH, Han DY, Jahng JS, Shin DE, Park JH (1998) Prevention of malrotation deformity in femoral shaft fracture. J Orthop Trauma 12(8):558–562

    Article  CAS  PubMed  Google Scholar 

  4. Bonnevialle P, Laques D, Fabre G, Mansat P, Rongieres M, Bellumore Y, Mansat M (2002) Femoral shaft fractures in the elderly treated by intramedullary nailing. Rev Chir Orthop Reparatrice Appar Mot 88(1):41–50

    CAS  PubMed  Google Scholar 

  5. Pfister U (2010) Reamed intramedullary nailing. Orthopade 39(2):171–181

    Article  CAS  PubMed  Google Scholar 

  6. Taitsman LA, Lynch JR, Agel J, Barei DP, Nork SE (2009) Risk factors for femoral nonunion after femoral shaft fracture. J Trauma 67(6):1389–1392

    Article  PubMed  Google Scholar 

  7. Lies A, Josten C, Muhr G (1993) Complications of intramedullary nailing and their prevention. Zentralbl Chir 118(6):342–350

    CAS  PubMed  Google Scholar 

  8. Sabat D, Wangchuk T, Dhal A (2014) Inadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing. Chin J Traumatol 17(2):118–120

    PubMed  Google Scholar 

  9. Riehl JT, Widmaier JC (2009) Techniques of obtaining and maintaining reduction during nailing of femur fractures. Orthopedics 32(8):581

    Article  PubMed  Google Scholar 

  10. Ziran BH, Morganstein A (2014) Preventing eccentric reaming of the trochanter during trochanteric nailing. J Orthop Trauma 28(4):e88–90

    Article  PubMed  Google Scholar 

  11. Ciftdemir M, Tuncel SA, Ozcan M, Copuroglu C, Erem M (2015) Does electromagnetic-manual guided distal locking influence rotational alignment in antegrade femoral nailing? Int Orthop 39(3):507–512

    Article  PubMed  Google Scholar 

  12. Chen W, Wang J, Su YL, Zhang Q, Wang B, Li ZY, Zhang YZ (2011) Comparison of two kinds of intramedullary nails in the treatment of femoral shaft fractures in adults. Chin Med J (Engl) 124(23):3900–3905

    Google Scholar 

  13. Barquet A, Francescoli L, Rienzi D, Lopez L (2000) Intertrochanteric-subtrochanteric fractures: treatment with the long Gamma nail. J Orthop Trauma 14(5):324–328

    Article  CAS  PubMed  Google Scholar 

  14. Aiyer S, Jagiasi J, Argekar H, Sharan S, Dasgupta B (2006) Closed antegrade interlocked nailing of femoral shaft fractures operated up to 2 weeks postinjury in the absence of a fracture table or C-arm. J Trauma 61(2):457–460

    Article  PubMed  Google Scholar 

  15. Kim KC, Lee JK, Hwang DS, Yang JY, Kim YM (2007) Stabilizing subtrochanteric femoral fractures with an interlocked intramedullary nail using the 'Joystick' technique. Orthopedics 30(9):705–708

    PubMed  Google Scholar 

  16. Faraj AA, Johnson VG (2002) Penetration injury of the hindfoot following intramedullary nail fixation of a tibial fracture. Acta Orthop Belg 68(2):178–181

    CAS  PubMed  Google Scholar 

  17. Rajappa S, Kumar NS (2009) Unusual complication following intramedullary nailing of tibia: a case report. Cases J 2:7343

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

    Authors and Affiliations

    1. Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, People’s Republic of China

      Wei Chen, Yongmin Jing, Hongzhi Lv, Juan Wang, Zhiyong Hou & Yingze Zhang

    Authors
    1. Wei Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Yongmin Jing
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Hongzhi Lv
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Juan Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Zhiyong Hou
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Yingze Zhang
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Yingze Zhang.

    Ethics declarations

    Conflict of interest

    This study was supported by the National Natural Science Foundation of China (Grant No. 81401789). No other conflict of interest exits.

    Additional information

    Wei Chen and Yongmin Jing contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Chen, W., Jing, Y., Lv, H. et al. Displaced femoral shaft fractures treated by antegrade nailing with the assistance of an intramedullary reduction device. International Orthopaedics (SICOT) 40, 1735–1739 (2016). https://doi.org/10.1007/s00264-015-3036-8

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00264-015-3036-8

    Keywords

    Search

    Navigation