Application of the New Self-dynamisable Internal Fixator in the Treatment of Femoral Shaft Fractures

Abstract

Summary The aim of this study was to present the results of one original method application in internal fixation of long bones. The series of 27 patients with unilateral fractures of femoral shaft was analyzed. According to AO classification, 21 fractures were classified as 32A, five as 32B, and one as 32C type. Original diaphyseal self-dynamisable internal fixator (model 1) was used as a fixation implant, consisting of three components: specially designed extramedullary bar, clamps and screws. The main feature of this implant is a possibility to become dynamic in the axial direction spontaneously if there is no sufficient fracture healing. Because of that, this implant is known as an „intelligent implant“. Surgical method included a standard surgical approach and minimally invasive surgical approach. Minimally invasive technique of application required less blood transfusion and shorter surgery time when compared to the standard surgical approach. The duration of used intraoperative fluoroscopy control was 7(3-18) seconds. The average healing time was 4.3 (3.5-9.5) months. There were neither intra operative nor postoperative complications. In comparison to intramedullary nails, self-dynamisable internal fixator provides a similar treatment results, while in comparison to plates it provides fewer mechanical complications. Self-dynamisable internal fixator method preserves periosteal and intramedullary blood circulation, and it is the first fixation implant with a possibility of spontaneous axial dynamising activation when needed. This implant has been proven as suitable for routine use in the treatment of femoral shaft fractures.