Risk Factors of Diaphyseal Femoral Nonunions: A Systematic Review and Meta-analysis.

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Abstract

[Indexed for MEDLINE] 2. Strategies Trauma Limb Reconstr. 2011 Nov;6(3):127-35. doi: 10.1007/s11751-011-0122-3. Epub 2011 Nov 13. Locked intramedullary femoral nailing without fracture table or image intensifier. Rohilla R(1), Singh R, Rohilla S, Magu NK, Devgan A, Siwach R. Author information: (1)Department of Orthopaedic Surgery, Paraplegia and Rehabilitation, Pt. B.D. Sharma PGIMS, 9 J/28, Medical Enclave, Rohtak, Haryana, 124001, India, drrajeshrohilla@rediffmail.com. The present retrospective study aims to evaluate the outcome in 41 patients of femoral shaft fractures, who had closed intramedullary nailing in lateral decubitus position without fracture table or image intensifier. Mean age was 33.2 (range, 18-70) years. The cannulated reamer in proximal fragment (as intramedullary joystick) and Schanz screw in the distal fragment (as percutaneous joystick) were simultaneously used to assist closed reduction of the fracture without the use of image intensifier. Closed reduction was successful in 38 patients. Open reduction was required in 3 patients. Schanz screw was used for closed reduction in 12 patients. Average number of intra-operative radiographic exposures was 4.4. Two patients had exchange nailing using large diameter nails. One patient had nonunion. Angular and rotatory malalignments were observed in seven patients. We are of the opinion that the present technique is a safe and reliable alternative to achieve closed locked intramedullary nailing and is best suited to stable, less comminuted (Winquist-Hansen types I and II) diaphyseal fractures of the femur. DOI: 10.1007/s11751-011-0122-3 PMCID: PMC3225568