Abstract:
PURPOSE:To compare the outcomes of simple versus complicated femoral shaft fracture (FSF) treated by early intramedullary nail. METHODS:Retrospective cohort study in level 1 trauma center including patients with FSF. Management consisted of intramedullary nailing (IMN) after adequate resuscitation within 24 h. Data were prospectively collected on admission (trauma base) consisted of demographics, biological parameters, associated injuries and injury severity score (ISS). Complicated fractures consisted of type C fracture or any type associated with bilateral femur fracture, floating knee, associated femoral neck fracture, dislocated hip, concomitant neurovascular injury. Simple fractures were Isolated type A and B fracture. Simple and complicated fracture groups were compared using stratification by ISS (ISS < 16; 16 ≤ ISS < 25; ISS ≥ 25). RESULTS:Inclusion of 191 consecutive patients: simple FSF (N = 109) versus complicated FSF (N = 82) (type 32C, n = 36; bilateral, n = 44; associated neck of femur fracture, n = 15; floating knee, n = 36; concomitant femoral artery injury, n = 3 or sciatic nerve injury, n = 7). Complicated fractures were associated with higher rate of associated injuries (thoracic, 56.1 vs. 40.4%, p = 0.04; head 25.6 vs 10.1%, p = 0.005) and ARDS (12.2% vs. 3.7%, p = 0.046); longer ICU stay (12.8 vs. 7.3 days, p = 0.019) and hospital stay (24.3 vs. 15.7 days, p < 0.001). After stratification, differences in morbidity between simple and complicated FSF were significant solely in range 16≤ISS < 25. Complicated fractures had longer operation duration (297 vs. 151 min, p < 0.001) due to additional IMN (tibial, humeral) requirements (24% vs. 1.8%, p < 0.001) and longer femoral IMN duration (133 vs. 104 min, p < 0.05). Pseudarthrosis was higher in complicated fracture group (9.6 vs. 3.7%, p = 0.002). CONCLUSION:Complicated femoral fractures are associated with higher morbidity, especially in less severely injured polytrauma, which eventually results in longer hospital stay. Patients with moderate ISS and complicated fracture may have an increased risk of ARDS.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Dukan R,Trousselier M,Briand S,Hamada S,Molina V,Court C,Bouthors Cdoi
10.1007/s00402-019-03325-1subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1037-1045issue
8eissn
0936-8051issn
1434-3916pii
10.1007/s00402-019-03325-1journal_volume
140pub_type
杂志文章abstract::It is often not feasible to conduct large trials in orthopaedic surgery. Therefore, surgeons must identify strategies to optimize the statistical power of their smaller studies. The aim of this study was to compare study power in randomized trials with continuous versus dichotomous outcome variables. We performed a sy...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020100347
更新日期:2002-03-01 00:00:00
abstract::Dorsal dislocation of the interphalangeal (IP) joint of the thumb is a rare injury, and closed dislocation without fracture is especially unusual. We present here two cases of closed dislocation of the thumb which were reduced by manipulation. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00434563
更新日期:1996-01-01 00:00:00
abstract::A total of 20 hip joints of 10 non-fixed corpses were examined within 48 h of death to measure the pressure below the inguinal ligament simulating the surgical conditions during total hip arthroplasty. The purpose of this study was to assess the influence of various leg positions and insertion techniques of retractors...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050216
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:The Less Invasive Stabilization System (LISS) is an internal fixator that can be inserted percutaneously by means of a minimally invasive surgical approach. This paper presents the use of this system exclusively in patients with AO33 distal femoral fractures, a group in which fracture management is often c...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s00402-004-0779-x
更新日期:2005-03-01 00:00:00
abstract:INTRODUCTION:Recurrent posterior glenohumeral instability poses a challenge for treatment. Bone block procedures have been advocated in cases where a bony defect is present. However, these techniques are not free of complications due to the proximity of neurovascular structures. The aim of this study is to measure the ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-2986-x
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Entrapment of the medial heel region nerves is often mentioned as a possible cause of heel pain. Some authors have suggested that the medial and inferior calcaneal nerves may be involved in such heel pain, including plantar fasciitis, heel pain syndrome and fat pad disorders. The aim of this study was to g...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0088-z
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:This study evaluated the incidence, amount, morphology and clinical significance of bone tunnel widening (TW) at a mean 5-year period after anterior cruciate ligament reconstruction (ACLR) with a transtibial drilling technique. METHODS:Fifty-nine patients undergoing primary ACLR using quadrupled hamstring a...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1596-2
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Either one- or two-stage revision arthroplasties can be used for the treatment of chronic periprosthetic joint infection (PJI) after total hip arthroplasty (THA). We report our results following two-stage revision surgery performed through the direct anterior approach (DAA) interval using a custom-made artic...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03317-1
更新日期:2020-02-01 00:00:00
abstract::The presence of large and massive segmental defects of the diaphyseal bone following tumor resection is a significant problem for orthopedic surgeons. Double or folded free vascularized fibula graft (FVFG) is used in massive femur defects and is considered to be a reliable reconstructive procedure. However, folded or ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0615-9
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:Radial neuropathy represents a devastating complication in a posterior approach to the distal humerus. This study aimed to propose "safe zones" regarding the radial nerve (RN) location at the posterior aspect of the humerus to minimize the risk of iatrogenic injury. METHODS:In 100 embalmed specimens, the dista...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2300-0
更新日期:2015-11-01 00:00:00
abstract::The reasons are discussed for differences in functional results of the pelvic osteotomy after Chiari, regardless of the fact that the CE and AC angles were equal in all patients. When lateralization and distal displacement of the greater trochanter were performed in addition to the pelvic osteotomy, the functional res...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00932167
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to review the clinical and radiographic outcomes and report the major complications in a group of hips with Crowe type IV developmental dysplasia that underwent reconstruction with a cementless total hip arthroplasty and a transverse subtrochanteric shortening osteotomy fixed ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1560-1
更新日期:2012-10-01 00:00:00
abstract::Osteotomy for osteoarthritis of the knee has established itself well since its first description by Jackson and Waugh [8, 9]. Internal fixation with staples allows early functional treatment with only a minimum of operative intervention. Removal of the metal is optional. In the 5-year period from 1986 to 1990, 182 hig...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00571479
更新日期:1992-01-01 00:00:00
abstract::Nineteen severely affected hips in 12 young patients with ankylosing spondylitis were treated with bipolar hip arthroplasty followed by a comprehensive postoperative rehabilitation programme. Additional operative procedures of adductor tenotomy, knee flexion release, supracondylar femoral osteotomy for genu valgum and...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00573449
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to identify the factors that may lead to poor outcomes after arthroscopic debridement in massive rotator cuff tears. MATERIALS AND METHODS:Thirty-three patients (10 women and 23 men) with massive, irreparable rotator cuff tears underwent arthroscopy by a single surgeon. The p...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-004-0738-6
更新日期:2005-05-01 00:00:00
abstract::Osteosarcoma was detected in two siblings. Their human leukocyte antigen (HLA) phenotypes were completely identical, although they were different from those of osteosarcoma patients in previous reports. Despite an extensive search of family and past history, no significant background related to the induction of cancer...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050479
更新日期:2000-01-01 00:00:00
abstract::Bladder herniation associated with pubic symphysis diastasis is a very rare condition. We report a case with bladder herniation after traumatic pubic symphysis disruption. The patient was treated with open reduction of the bladder and definitive internal fixation of the pubis. We used a bone allograft for closure of t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0290-2
更新日期:2007-10-01 00:00:00
abstract::To improve the technique of intraoperative sonography of the spinal canal, a teaching model of the thoracolumbar spine was developed. It allows to simulate the typical spinal stenosis of a vertebral fracture and the sonographic procedure to detect and measure such a lesion. Moreover, partial laminectomy and modificati...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050040
更新日期:2000-01-01 00:00:00
abstract::The most common fracture of the proximal fifth metatarsal is the tuberosity avulsion fracture. Most of the time, the fracture is relatively undisplaced and it can be treated conservatively with a hard-soled shoe or walking cast. For painful intra-articular nonunion, internal fixation with or without bone graft is the ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0556-8
更新日期:2008-11-01 00:00:00
abstract::This is a report of a 2-year follow-up of a missed posterior shoulder dislocation treated with open reduction and glenoid reconstruction with corticocancellous iliac bone autograft. In such cases, this treatment option may be an alternative to hemiarthroplasty of the shoulder. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-004-0693-2
更新日期:2004-07-01 00:00:00
abstract:INTRODUCTION:The purposes of this study were: (1) to compare tunnel locations using the conventional transtibial technique with reference data, and (2) to identify factors that make it difficult to position the femoral tunnel correctly or contribute to breakage of the bone bridge between the two tibial tunnels. MATERI...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1780-z
更新日期:2013-08-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2781-0
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:To analyze the radiographic and clinical outcomes of deltoid ligament repair, we studied 34 supination external rotation type IV ankle fracture patients with deltoid ruptures who required syndesmosis fixation. METHODS:We retrospectively evaluated 34 cases of ruptured deltoid ligaments with associated supinatio...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03645-7
更新日期:2020-10-29 00:00:00
abstract:BACKGROUND AND PURPOSE:Review the literature concerning modalities to evaluate the integrity of the deltoid ligament in patients with supination external rotation ankle fractures. METHODS:The electronic databases Pubmed/Medline, CINAHL and Embase were searched from 1987 to November 2007 to identify all published origi...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00
abstract:INTRODUCTION:The German national nosocomial infections surveillance system (KISS) has been collecting surveillance data from hip and knee prosthesis operations since 1997. The purpose of this article is to investigate whether surveillance and feedback of surgical site infection (SSI) information to the physicians and n...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0036-y
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:The treatment of fractures of the distal tibia can be problematical because of the thin soft-tissue covering. Bridging slide-insertion plate osteosynthesis is performed by indirect, axially correct reduction of the fracture and stabilization without opening the soft tissue at the fracture site. Stripping o...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-004-0778-y
更新日期:2005-03-01 00:00:00
abstract::Synovial hemangioma is a benign vascular tumor. While mainly affecting the knee, it can also appear in other joints or tissues. The condition is very rare in children. A delay between debut and diagnosis due to its unspecific symptomatology is common. We report a case of a boy affected by an intra-articular synovial h...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0414-8
更新日期:2008-06-01 00:00:00
abstract::Dipygus or pygomelia is an incomplete form of twinning due to the incomplete division of the embryonic disc. This extremely rare condition consists in the presence of an accessory limb that generally inserts into the buttock or perineum. Associated anomalies such as duplication of the genitourinary or the intestinal t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-1987-7
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:The reliability of joint line tenderness was previously investigated among other clinical tests for the diagnosis of meniscal pathology with variable results. The aim of this study was to evaluate and compare the accuracy of joint line tenderness as a clinical diagnosing test for arthroscopically confirmed...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2305-8
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:To investigate whether tibial tubercle fracture affected clinical outcomes and bony union in medial opening wedge high tibial osteotomy with distal tibial tubercle osteotomy (DTO) and to determine the anatomical risk factors for tibial tubercle fracture. MATERIALS AND METHODS:All patients who underwent DTO wer...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03688-w
更新日期:2020-11-23 00:00:00