Plate fixation of femoral nonunions over an intramedullary nail with autogenous bone grafting.

Abstract:

OBJECTIVE:To describe a novel approach for the treatment of nonunions of diaphyseal femur fractures. DESIGN:Retrospective review. SETTING:University hospital. PATIENTS:Seven patients (six men, one woman, average age 42.5 years) with diaphyseal femoral fracture nonunions treated between November 2006 and November 2007 were reviewed. The injuries included two open and five closed fractures. All were treated initially with intramedullary nail fixation (two antegrade, five retrograde) and went on to develop a symptomatic nonunion by radiographic and clinical criteria. INTERVENTION:Nonunions were treated with operative débridement of the nonunion with plate fixation and autogenous bone grafting without removal or exchange of the intramedullary nail. MAIN OUTCOME MEASURES:Clinical criteria of decreased pain and return to function as well as radiographic evidence of fracture consolidation. RESULTS:All patients demonstrated radiographic evidence of fracture consolidation with an average follow-up time of 17.9 months (range 12-26 months). All were allowed immediate weightbearing and reported decreased pain with improved function. Six patients reported absolutely no pain with ambulation as related to the fracture site, whereas one noted discomfort about the distal femoral compression plate. Independent ambulation was observed in six subjects. None of the patients required additional operations for implant removal or bone grafting procedures. CONCLUSION:Treatment of diaphyseal femoral fracture nonunion after intramedullary nail fixation with large fragmentary compression plating and bone grafting is a reasonable option, especially for complex fractures about the metadiaphyseal region. The procedure appears to be successful in reducing pain, improving function, and predictably leads to radiographic consolidation of the nonunion.

journal_name

J Orthop Trauma

authors

Hakeos WM,Richards JE,Obremskey WT

doi

10.1097/BOT.0b013e3181dfbb33

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

84-9

issue

2

eissn

0890-5339

issn

1531-2291

pii

00005131-201102000-00004

journal_volume

25

pub_type

杂志文章
  • Femoral cortical stress lesions in long-term bisphosphonate therapy: a herald of impending fracture?

    abstract:OBJECTIVE:Lateral cortical stress reactions have been documented to precede femoral insufficiency fractures after long-term bisphosphonate therapy. We studied the natural history of femoral stress lesions associated with long-term bisphosphonate therapy. DESIGN AND SETTING:A retrospective clinical and radiologic revie...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181b6499b

    authors: Koh JS,Goh SK,Png MA,Kwek EB,Howe TS

    更新日期:2010-02-01 00:00:00

  • Histomorphometry of distraction osteogenesis during experimental tibial lengthening.

    abstract:OBJECTIVES:The aim of the current study was to analyze distraction osteogenesis histomorphometrically to investigate the amount of enchondral ossification adjacent to intramembranous ossification. STUDY DESIGN:Species-specific, longitudinal time study. METHODS Lengthening of 25% of the right tibia was performed in 24 ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200302000-00006

    authors: Fink B,Pollnau C,Vogel M,Skripitz R,Enderle A

    更新日期:2003-02-01 00:00:00

  • Functional outcome after isolated acetabular fractures.

    abstract:OBJECTIVE:To evaluate objectively the effectiveness of current surgical management of displaced acetabular fractures. To provide insight into how these evaluation methods can be used to identify areas in which improvements in surgery and rehabilitation can be pursued to improve patient outcomes. DESIGN:Consecutive cas...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200202000-00001

    authors: Borrelli J Jr,Goldfarb C,Ricci W,Wagner JM,Engsberg JR

    更新日期:2002-02-01 00:00:00

  • Treatment of displaced, proximal, humeral, epiphyseal fractures with a two-prong splint.

    abstract::To evaluate the use of a two-prong splint for displaced, proximal, humerus, epiphyseal fractures, seven children with Neer-Horwitz Classification Type 3-4 fractures of the proximal humerus were retrospectively investigated. After closed reduction, fracture stabilization was accomplished with the use of a two-prong spl...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200309000-00007

    authors: Karatosun V,Unver B,Alici E,Serin E

    更新日期:2003-09-01 00:00:00

  • In vitro femoral stiffness after femoral neck osteotomy and osteosynthesis with defined surgical errors.

    abstract::In our search for an osteosynthesis device that would tolerate the surgical errors of the inexperienced surgeon, we tested in vitro femoral stiffness in 75 human osteoporotic femora after internal fixation of a cervical neck osteotomy using three commonly used devices: two von Bahr screws (A. Ericsson AB, Sweden), two...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199608000-00009

    authors: Hernefalk L,Messner K

    更新日期:1996-01-01 00:00:00

  • Vascular abnormalities as assessed with CT angiography in high-energy tibial plafond fractures.

    abstract:OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 t...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31815cf6e9

    authors: LeBus GF,Collinge C

    更新日期:2008-01-01 00:00:00

  • The Size of Intramedullary Fixation Affects Endochondral-Mediated Angiogenesis During Fracture Repair.

    abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001555

    authors: Yuasa M,Saito M,Blum DM,Hysong AA,Egawa S,Uppuganti S,Yoshii T,Okawa A,Schwartz HS,Moore-Lotridge SN,Nyman JS,Schoenecker JG

    更新日期:2019-10-01 00:00:00

  • Non-invasive low-intensity pulsed ultrasound accelerates bone healing in the rabbit.

    abstract::The effect of ultrasound (US) on the rate of fibula osteotomy healing in 139 mature New Zealand white rabbits was assessed in this study. Bilateral midshaft fibular osteotomies were made using a 1-mm Gigli saw. US was noninvasively applied to one limb for 20 minutes daily, while the contralateral limb served as a cont...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199004030-00002

    authors: Pilla AA,Mont MA,Nasser PR,Khan SA,Figueiredo M,Kaufman JJ,Siffert RS

    更新日期:1990-01-01 00:00:00

  • Intraoperative CT and Surgical Navigation for Iliosacral Screws: Technique for Patients With Sacral Dysmorphism.

    abstract::Percutaneous iliosacral screw (IS) fixation for pelvic ring injuries with the use of an O-arm imaging system has been associated with decreased procedure time and improved accuracy of IS screw placement compared with the use of fluoroscopic guidance. Specifically, patients with sacral dysmorphism require identificatio...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001213

    authors: Khan JM,Lara DL,Marquez-Lara A,Rosas S,Hasty E,Pilson HT

    更新日期:2018-08-01 00:00:00

  • Multiple Procedures in the Initial Surgical Setting: When Do the Benefits Outweigh the Risks in Patients With Multiple System Trauma?

    abstract:OBJECTIVES:To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN:Prospective, cohort. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:A total...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000556

    authors: Childs BR,Nahm NJ,Moore TA,Vallier HA

    更新日期:2016-08-01 00:00:00

  • A mechanical study of gap motion in cadaveric femurs using short and long supracondylar nails.

    abstract:OBJECTIVE:To determine the relative stability achieved in unstable supracondylar femur fractures treated with long (36 cm) and short (20 cm) retrograde intramedullary nails using 1 or 2 proximal locking bolts. We hypothesized that longer nails would reduce fracture site motion compared with short nails and that 2 proxi...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200407000-00004

    authors: Sears BR,Ostrum RF,Litsky AS

    更新日期:2004-07-01 00:00:00

  • Ulnar-styloid nonunion and partial rupture of extensor carpi ulnaris tendon: two case reports and review of the literature.

    abstract::Two unusual cases of symptomatic partial rupture of the extensor carpi ulnaris tendon associated with ulnar-styloid nonunion are described. Intraoperative findings suggested that the jagged surface of the distal ulna was the cause of flaying. In one case, debridement of the frayed extensor carpi ulnaris tendon and fix...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-200210000-00011

    authors: Kiyono Y,Nakatsuchi Y,Saitoh S

    更新日期:2002-10-01 00:00:00

  • Angular malalignment after intramedullary nailing of femoral shaft fractures.

    abstract:OBJECTIVES:To determine factors associated with angular malalignment of femoral shaft fractures treated with intramedullary nails and to determine differences in the incidence of angular malalignment based on fracture location, fracture comminution, and method of treatment (i.e., antegrade or retrograde). DESIGN:Retro...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200102000-00003

    authors: Ricci WM,Bellabarba C,Lewis R,Evanoff B,Herscovici D,Dipasquale T,Sanders R

    更新日期:2001-02-01 00:00:00

  • Observed and expected outcomes in transfer and nontransfer patients with a hip fracture.

    abstract:OBJECTIVES:Hospitals and providers that accept transfer patients risk lower ratings on publically reported quality measures that are inadequately adjusted for infirmity and complexity. We compared the outcomes of transferred patients and nontransferred patients after treatment of a hip fracture and sought to determine ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31821146b1

    authors: Wiggers JK,Guitton TG,Smith RM,Vrahas MS,Ring D

    更新日期:2011-11-01 00:00:00

  • The effects of clopidogrel (Plavix) and other oral anticoagulants on early hip fracture surgery.

    abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318240d70f

    authors: Collinge CA,Kelly KC,Little B,Weaver T,Schuster RD

    更新日期:2012-10-01 00:00:00

  • Avoiding rotational mismatch of locking distal tibia plates depends on proper plate position.

    abstract:OBJECTIVES:The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia. METHODS:We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31827cd67d

    authors: Song HK,Noh JW,Lee JH,Yang KH

    更新日期:2013-07-01 00:00:00

  • The Effect of Implant Failure After Symphyseal Plating on Functional Outcome and General Health.

    abstract:OBJECTIVES:To relate the incidence of implant failure after internal anterior fixation of the pelvic ring to functional outcome and the health-related quality of life in patients. DESIGN:Retrospective chart and radiographic review. SETTING:Level I Trauma center. METHODS:We retrospectively identified all patients who...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000501

    authors: Frietman B,Verbeek J,Biert J,Frölke JP

    更新日期:2016-06-01 00:00:00

  • Rotational imaging of complex acetabular fractures.

    abstract::Understanding complex acetabular fractures is difficult and may require three-dimensional reformatted computed tomographic (CT) images. This paper evaluates a technique, digital rotational imaging (DRI), that displays multiple oblique images of the pelvis and acetabulum. When viewed statically, DRI provides optimal il...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199801000-00011

    authors: Patel NH,Hunter J,Weber TG,Routt ML Jr

    更新日期:1998-01-01 00:00:00

  • Radiographic fracture assessments: which ones can we reliably make?

    abstract:OBJECTIVE:To identify the fracture characteristics that can be reliably assessed by analysis of plain radiographs of tibial plateau fractures. DESIGN:Radiographic review study. PARTICIPANTS:Five orthopaedic traumatologists served as observers. INTERVENTION:Observers made assessments based on the radiographs of fifty...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200008000-00001

    authors: Martin J,Marsh JL,Nepola JV,Dirschl DR,Hurwitz S,DeCoster TA

    更新日期:2000-08-01 00:00:00

  • Randomized, prospective comparison of plate versus intramedullary nail fixation for distal tibia shaft fractures.

    abstract:OBJECTIVES:Malalignment has been frequently reported after intramedullary stabilization of distal tibia fractures. Nails have also been associated with knee pain in several studies. Historically, plate fixation has resulted in increased risks of infection and nonunion. Our purposes were to compare plate and nail stabil...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BOT.0b013e318213f709

    authors: Vallier HA,Cureton BA,Patterson BM

    更新日期:2011-12-01 00:00:00

  • Biomechanical Stability of Volar Plate Only Versus Addition of Dorsal Ulnar Pin Plate: A Dorsal Ulnar Fragment, C-3-Type, Distal Radius, Cadaver Fracture Model.

    abstract:OBJECTIVE:To determine if the addition of a dorsal ulnar pin plate provides improved stability characteristics in the management of intra-articular distal radius fractures with an associated dorsal ulnar fragment. METHODS:OTA/AO type C3 fractures, with a dorsal ulnar fragment of one-third or one-half the width of the ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001776

    authors: Patrick NC,Lewis GS,Roush EP,Black SS,Henderson SR,Taylor KF

    更新日期:2020-09-01 00:00:00

  • Evaluation of the mangled extremity severity score in combat-related type III open tibia fracture.

    abstract:OBJECTIVES:The purpose of this study was to determine the extent to which the Mangled Extremity Severity Score (MESS) predicted outcomes for soldiers sustaining combat-related Gustilo-Anderson type III open tibia fractures. DESIGN:Retrospective cohort study. SETTING:Tertiary trauma center. PATIENTS:Service Members w...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000054

    authors: Sheean AJ,Krueger CA,Napierala MA,Stinner DJ,Hsu JR,Skeletal Trauma and Research Consortium (STReC).

    更新日期:2014-09-01 00:00:00

  • Regeneration of segmental diaphyseal defects in sheep tibiae using resorbable polymeric membranes: a preliminary study.

    abstract:OBJECTIVE:To investigate whether a long bone cortex of well-defined thickness can be regenerated by using an anatomically designed membranous resorbable "tube-in-tube" implant and to establish the functions of membranes in the healing of segmental diaphyseal bone defects larger than the "critical size." DESIGN:Bone he...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199903000-00006

    authors: Gugala Z,Gogolewski S

    更新日期:1999-03-01 00:00:00

  • Intraoperative fluoroscopy to evaluate fracture reduction and hardware placement during acetabular surgery.

    abstract:OBJECTIVES:To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws. DESIGN:Retrospective. SETTING:Level I trauma center. PARTICIPANTS:Thirty patients with thirty-two acetabular fractures. INTERVENTION:Patients were evaluated with fluor...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199908000-00004

    authors: Norris BL,Hahn DH,Bosse MJ,Kellam JF,Sims SH

    更新日期:1999-08-01 00:00:00

  • Anatomic Fixation of Supination External Rotation Type IV Equivalent Ankle Fractures.

    abstract:OBJECTIVES:To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation with those treated with deltoid and posterior inferior tibiofibular ligament (PITFL) repair. DESIGN:Case se...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000318

    authors: Little MM,Berkes MB,Schottel PC,Garner MR,Lazaro LE,Birnbaum JF,Helfet DL,Lorich DG

    更新日期:2015-05-01 00:00:00

  • Intraarticular calcaneus fractures: a biomechanical comparison or two fixation methods.

    abstract:OBJECTIVE:To compare the strength of fixation obtained using two unicortical 4.0 mm diameter cancellous screws versus two bicortical 3.5 mm diameter cortical screws in the fixation of intra-articular calcaneus fractures. DESIGN:In eight paired fresh frozen cadaver feet, the subtalar joint complex, consisting of the ta...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199701000-00008

    authors: Bailey EJ,Waggoner SM,Albert MJ,Hutton WC

    更新日期:1997-01-01 00:00:00

  • Can We Estimate the Amount of Malrotation in Supracondylar Humerus Fractures After CRPP?

    abstract:BACKGROUND:Acceptable amounts of malrotation after CRPP for pediatric supracondylar humerus fracture (SCHFx) have yet to be defined. This is an attempt to correlate radiographic parameters of a malrotated SCHFx with degrees of rotational malalignment to assist intraoperative assessment of reduction. METHODS:3D models ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001735

    authors: Prabhakar P,Pierce WA,Standefer KD,Ho CA

    更新日期:2020-07-01 00:00:00

  • Consortium of Orthopaedic Academic Traumatologists: A Model for Collaboration in Orthopaedic Surgery.

    abstract::In March 2016, North American academic leaders with an interest in and commitment to the field of global orthopaedics met in Orlando, Florida, to gauge each institution's clinical, research, and educational programs in developing countries, establish the main limitations to participating in global health efforts, and ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001288

    authors: Miclau T,MacKechnie MC,Shearer DW,COACT group.

    更新日期:2018-10-01 00:00:00

  • Incision placement for intramedullary tibial nailing: an anatomic study.

    abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200211000-00001

    authors: Althausen PL,Neiman R,Finkemeier CG,Olson SA

    更新日期:2002-11-01 00:00:00

  • Immediate interlocking nailing of fractures of the femur caused by low- to mid-velocity gunshots.

    abstract::A retrospective review of 39 fractures of the femur in 37 patients caused by low- and mid-velocity handgun missiles treated with static interlocking nailing within 18 h of injury was conducted to evaluate the efficacy, safety, and cost savings of immediate intramedullary nailing in these injuries. Patients were follow...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199404000-00010

    authors: Nowotarski P,Brumback RJ

    更新日期:1994-01-01 00:00:00