Abstract
A novel reduction technique of intramedullary nailing (IMN) for femoral shaft fractures was introduced, and in this study, its therapeutic effect was compared with patients treated with the traditional traction table. From November 2012 to August 2015, the patients with femoral shaft fractures fixed with anterograde IMN were reviewed. Seventy-four patients treated with the traction table and forty-eight patients treated with the double reverse traction repositor (DRTR) met the inclusion criteria of this study. The surgical time, blood loss, open reduction rate and complications were reviewed in this study. The fracture healing was assessed by the radiographs conducted at each follow-up. The functional outcome (hip and knee flexion, Harris Hip Score, and Lysholm knee score) was evaluated at the final follow-up. Average surgical time, blood loss, hip and knee flexion, and Harris Hip Score showed no difference (P > 0.05) between the two groups. However, the DRTR was superior to the traction table in fracture healing, Lysholm knee score, open reduction and complications rate (P < 0.05). Thus, we concluded that minimally invasive treatment of femoral shaft fractures could be obtained with the DRTR.
Highlights
Femoral shaft fractures, mostly caused by high-energy trauma, are not uncommon clinically[1,2]
Open reduction was indispensable to accomplish the intramedullary nailing (IMN) fixation if the guiding wire could not pass through the distal fracture site[12,13]
Our results showed that the double reverse traction repositor (DRTR) was superior to the traction table in fracture healing, Lysholm knee score, open reduction and complication rate
Summary
Mostly caused by high-energy trauma, are not uncommon clinically[1,2]. The traction table could provide continuous and stable tractive strength on the fragments of the lower extremity (Fig. 1A) It has been widely employed in the IMN surgical procedure for femoral shaft fractures[9,10]. Open reduction was indispensable to accomplish the IMN fixation if the guiding wire could not pass through the distal fracture site[12,13] This surgical procedure would seriously damage the blood supply to fragments, which may lead to oligotrophic nonunion[14,15,16]. A high incidence of complications, including neurologic and soft-tissue injuries (Fig. 1C), may be accompanied by application of the traction table[1,18,19] To resolve these problems, the authors designed a novel reduction tool called the double reverse traction repositor (DRTR). The second purpose was to compare the therapeutic results of two different reduction techniques (the traction table and the DRTR)
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