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 followed through union of the fracture with an average follow-up of 12.5 months. The average hospitalization was 8.5 days. All but two fractures healed in an average of 14 weeks (range 8-28). One delayed union was treated with exchange intramedullary nailing with reaming 5 months postinjury and progressed uneventfully to fracture union. One nonunion occurred, presenting with broken distal interlocking screws 18 months after injury, which was treated with an exchange intramedullary nailing with reaming. The nonunion healed within 4 months of this secondary procedure. There were no malunions of > 5 degrees angulation, no leg length discrepancies of > 1.0 cm, and no rotational malalignments noted. There was one (2.5%) infection that was successfully treated with nail removal, reaming of the canal, and reinsertion of a larger diameter nail. We conclude that immediate interlocking nailing of low- and mid-velocity gunshot fractures of the femur is an effective and safe treatment. Compared with previously published data on intramedullary nailing of femoral gunshot fractures, immediate intramedullary nailing resulted in a shorter hospital stay with a significant decrease in hospital expenses. Because the findings of this study indicate that early fixation in these injuries had no detrimental effect on the clinical results, we recommend immediate intramedullary nailing of gunshot fractures of the femur.

journal_name

J Orthop Trauma

authors

Nowotarski P,Brumback RJ

doi

10.1097/00005131-199404000-00010

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

134-41

issue

2

eissn

0890-5339

issn

1531-2291

journal_volume

8

pub_type

杂志文章
  • Retrograde nailing of humeral shaft fractures: a biomechanical study of its effects on the strength of the distal humerus.

    abstract:OBJECTIVES:The purpose of this study was to evaluate the loss of strength in the distal humerus that resulted from the creation of two different entry portals used for retrograde humeral nailing. DESIGN:Nine pairs, treated as blocks of size two, of fresh frozen humeri from individuals free of musculoskeletal disease w...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200002000-00005

    authors: Strothman D,Templeman DC,Varecka T,Bechtold J

    更新日期:2000-02-01 00:00:00

  • Intramedullary nailing of the femoral shaft: a prospective, randomized study.

    abstract::We conducted a prospective, randomized study on 84 consecutive patients with 88 acute, traumatic femoral shaft fractures using 32 Grosse-Kempf nails, 29 Russell-Taylor nails, and 27 Synthes nails. Although total operative times and proximal and distal locking times were similar for the three groups, the procedure was ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BOT.0000000000000185

    authors: Cameron CD,Meek RN,Blachut PA,O'Brien PJ,Pate GC

    更新日期:2014-08-01 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

  • Management protocol for unreamed interlocking tibial nails for open tibial fractures.

    abstract::Over a 15-month period, 41 open grade I-IIIA tibia fractures were treated with unreamed interlocking nails. A protocol previously established by the authors to enhance fracture union was followed. The purpose of the study was to determine if union rate for the comminuted statically locked fracture could be reduced thr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199504000-00005

    authors: Stegemann P,Lorio M,Soriano R,Bone L

    更新日期:1995-04-01 00:00:00

  • Mathematical precision in rotational corrective osteotomy of the femur.

    abstract::We used a mathematical model to determine whether the approach to derotation of the malrotated femur can be improved for use in corrective osteotomy of the femur. Rotational corrective osteotomy of the femur (RCOF) is a procedure performed by orthopedic surgeons to correct congenital femoral torsion deformities and po...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199806000-00012

    authors: Pulisetti TD,Onwochei MO,Ebraheim NA,Humphries C,Coombs RJ

    更新日期:1998-06-01 00:00:00

  • Greenstick fracture of the scapula: a cause of scapular winging.

    abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000174707.10980.f4

    authors: Bowen TR,Miller F

    更新日期:2006-02-01 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

  • 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 200...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181dfbb33

    authors: Hakeos WM,Richards JE,Obremskey WT

    更新日期:2011-02-01 00:00:00

  • Modern perspectives of open reduction and plate fixation of proximal humerus fractures.

    abstract::Recent innovations have greatly increased the range of proximal humeral fractures that are amenable to open reduction and plate fixation.The optimum technique for some of the more complex fracture patterns is not yet fully refined.This article aims to describe the recent advances in the treatment of complex proximal h...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0b013e31821c0a2f

    authors: Robinson CM,Amin AK,Godley KC,Murray IR,White TO

    更新日期:2011-10-01 00:00:00

  • Treatment of Gartland type III pediatric supracondylar humerus fractures with the Kapandji technique in the prone position.

    abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000015

    authors: Kao HK,Yang WE,Li WC,Chang CH

    更新日期:2014-06-01 00:00:00

  • Teamwork in Trauma: System Adjustment to a Protocol for the Management of Multiply Injured Patients.

    abstract:OBJECTIVES:We developed a protocol to determine the timing of definitive fracture care based on the adequacy of resuscitation. Inception of this project required a multidisciplinary group, including physicians from anesthesiology, general trauma and critical care, neurosurgery, orthopaedic spine, and orthopaedic trauma...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000383

    authors: Vallier HA,Moore TA,Como JJ,Dolenc AJ,Steinmetz MP,Wagner KG,Smith CE,Wilczewski PA

    更新日期:2015-11-01 00:00:00

  • The PFNA proximal femur nail in treatment of unstable proximal femur fractures--3 cases of postoperative perforation of the helical blade into the hip joint.

    abstract::The proximal femur nail antirotation represents a new generation of intramedullary nailing devices for fixation of stable and unstable trochanteric fractures of the proximal femur. We report 3 cases of postoperative perforation of the helical blade through the femoral head into the hip joint without any signs of rotat...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181893b1b

    authors: Brunner A,Jöckel JA,Babst R

    更新日期:2008-11-01 00:00:00

  • Biomechanical Assessment of Locked Plating for the Fixation of Patella Fractures.

    abstract:OBJECTIVE:To analyze the mechanical stability of locked plating in comparison with tension-band wiring for the fixation of fractures of the patella. METHODS:Biomechanical tests were performed on artificial foam patella specimens comparing an angular stable plate and monocortical screws with tension-band wiring. Tests ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000309

    authors: Wurm S,Augat P,Bühren V

    更新日期:2015-09-01 00:00:00

  • The combined olecranon osteotomy, lateral paratricipital sparing, deltoid insertion splitting approach for concomitant distal intra-articular and humeral shaft fractures.

    abstract::Fractures of the distal humerus involving the articular surface can be challenging. The complexity of these fracture patterns increases when the distal fracture is associated with a concomitant humeral shaft fracture with significant proximal extension. The combined exposure technique described here allows for consist...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000245988.23684.79

    authors: Lewicky YM,Sheppard JE,Ruth JT

    更新日期:2007-02-01 00:00:00

  • Vertically Oriented Femoral Neck Fractures: A Biomechanical Comparison of 3 Fixation Constructs.

    abstract:OBJECTIVES:To compare the static and dynamic mechanical properties of a modified crossed cannulated screw (CS) configuration, the inverted triangle (IT) cannulated screw configuration, and a compression hip screw (CHS) with derotation screw in Pauwels type III femoral neck fractures. METHODS:Thirty synthetic femora we...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000836

    authors: Johnson JP,Borenstein TR,Waryasz GR,Klinge SA,McClure PK,Chambers AB,Hayda RA,Born CT

    更新日期:2017-07-01 00:00:00

  • Magnetic Resonance Imaging of Trauma Patients Treated With Contemporary External Fixation Devices: A Multicenter Case Series.

    abstract:OBJECTIVES:To report the safety and clinical outcomes of placing current magnetic resonance imaging (MRI) components inside and outside the MRI bore during MRIs. DESIGN:Retrospective case series. SETTING:Four trauma centers (3 Level I and 1 Level II), from January 2005 to January 2015. PATIENTS:All patients who had ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000000954

    authors: Hayden BL,Theriault R,Bramlett K,Lucas R,McTague M,Bedi HS,Flacke S,Weaver MJ,Marcantonio AJ,Ryan SP

    更新日期:2017-11-01 00:00:00

  • Treatment of diaphyseal fractures of the humerus using a functional brace.

    abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000249423.48074.82

    authors: Rutgers M,Ring D

    更新日期:2006-10-01 00:00:00

  • Abductor Muscle Function and Trochanteric Tenderness After Hemiarthroplasty for Femoral Neck Fracture.

    abstract:OBJECTIVES:To compare the abductor muscle function and trochanteric tenderness in patients operated with hemiarthroplasty using the direct lateral (DL) or posterolateral (PL) approach for displaced femoral neck fracture. DESIGN:Prospective cohort study. SETTING:A secondary teaching hospital. PARTICIPANTS:We enrolled...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000532

    authors: Sayed-Noor AS,Hanas A,Sköldenberg OG,Mukka SS

    更新日期:2016-06-01 00:00:00

  • Mortality after pelvic fractures in the elderly.

    abstract::Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary embo...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-198906000-00005

    authors: Rossvoll I,Finsen V

    更新日期:1989-01-01 00:00:00

  • Closed elbow dislocation and brachial artery damage.

    abstract::Damage to the brachial artery associated with closed elbow dislocation but without accompanying fracture is rare. Only 25 cases have been reported to date. We present a case that responded well to brachial artery vein grafting, and review the literature on this subject. Operative repair is recommended in this uncommon...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-199312000-00012

    authors: Slowik GM,Fitzimmons M,Rayhack JM

    更新日期:1993-01-01 00:00:00

  • The Incidence and Risk Factors Associated With the Need for Fasciotomy in Tibia and Forearm Fractures: An Analysis of the National Trauma Data Bank.

    abstract:OBJECTIVE:The aims of this study were to analyze a large national trauma database to determine the incidence of, risk factors for, and outcomes after a fasciotomy of the lower leg or forearm after fracture. METHODS:Data from the National Trauma Data Bank for the years 2004-2016 were analyzed, and we identified 301,351...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001702

    authors: Saiz AM Jr,Wellman AC,Stwalley D,Wolinsky P,Miller AN

    更新日期:2020-05-01 00:00:00

  • Open fractures of the tibia treated by immediate intramedullary tibial nail insertion without reaming: a prospective study.

    abstract:OBJECTIVE:Does immediate tibial nail insertion without reaming as part of protocol-driven management provide a safe and effective treatment for open tibia fractures? STUDY DESIGN:Prospective cohort. SETTING:Level 1 trauma center. PATIENTS:A consecutive series of 161 patients with Gustilo grade I-IIIb open tibia frac...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3180336923

    authors: Kakar S,Tornetta P 3rd

    更新日期:2007-03-01 00:00:00

  • Femoral fractures in Paget's disease.

    abstract::Since the original description of osteitis deformans, the treatment of femoral fractures occurring in this disease process has been difficult. A retrospective study of 35 fractures treated over an 8-year period was undertaken to identify the factors that influenced the results. The fractures were classified according ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-198912000-00011

    authors: Bidner S,Finnegan M

    更新日期:1989-01-01 00:00:00

  • Biomechanical study of atlantoaxial arthrodesis: transarticular screw fixation versus modified Brooks posterior wiring.

    abstract:OBJECTIVE:The purpose of the present study was to compare the biomechanical stability of C1 and C2 vertebrae after treatment of ligamentous instability by either modified Brooks posterior wiring (MB) or transarticular screw (TAS) techniques. We hypothesized that the TAS technique would be more stable because of direct ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199909000-00004

    authors: Mitchell TC,Sadasivan KK,Ogden AL,Mayeux RH,Mukherjee DP,Albright JA

    更新日期:1999-09-01 00:00:00

  • Do locking screws work in plates bent at holes?

    abstract:OBJECTIVES:To assess whether plate bending at a hole significantly changes the biomechanical properties of a locked screw. METHODS:Coronal plane bends of 5-, 15-, or 45-degree angles were placed in 3.5-mm locking compression plates with the apex at a locking hole. An additional 45-degree angle test group was created i...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182a73a77

    authors: Boulton CL,Kim H,Shah SB,Ryan SP,Metzger TA,Hsieh AH,O'Toole RV

    更新日期:2014-04-01 00:00:00

  • A Machine Learning Algorithm to Predict the Probability of (Occult) Posterior Malleolar Fractures Associated With Tibial Shaft Fractures to Guide "Malleolus First" Fixation.

    abstract:OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using te...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001663

    authors: Hendrickx LAM,Sobol GL,Langerhuizen DWG,Bulstra AEJ,Hreha J,Sprague S,Sirkin MS,Ring D,Kerkhoffs GMMJ,Jaarsma RL,Doornberg JN,Machine Learning Consortium.

    更新日期:2020-03-01 00:00:00

  • Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail.

    abstract:OBJECTIVES:To compare the results between a new intramedullary Gamma nail and a compression hip screw in the treatment of trochanteric fractures. DESIGN:Prospective randomized. SETTING:Level 1 trauma center. PATIENTS:Two hundred ten consecutive patients older than 65 years with trochanteric femoral fractures. INTER...

    journal_title:Journal of orthopaedic trauma

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.bot.0000151819.95075.ad

    authors: Utrilla AL,Reig JS,Muñoz FM,Tufanisco CB

    更新日期:2005-04-01 00:00:00

  • Convergent radioulnar translocation with radial head fracture in a child: a case report and review of the literature.

    abstract:SUMMARY:Convergent type radioulnar translocation is an extremely rare form of injury occurring in a growing child. We report a case of convergent radioulnar translocation along with a radial head fracture in a young child. Open reduction of the elbow and internal fixation of the radial head fragment helped in achieving...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0b013e31821d7fd5

    authors: Agashe MV,Samant A,Aroojis AJ

    更新日期:2012-04-01 00:00:00

  • Comparison of the 95-degree angled blade plate and the locking condylar plate for the treatment of distal femoral fractures.

    abstract:OBJECTIVES:In the distal femur, locked plating is efficacious when coronal fractures preclude the use of a conventional fixed-angle device. However, minimal comparative data exist for supracondylar fracture patterns, which could be treated with other devices. The purpose of this study was to compare the 95-degree angle...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e318234d460

    authors: Vallier HA,Immler W

    更新日期:2012-06-01 00:00:00

  • Barefoot stubbing injuries to the great toe in children: a new classification by injury mechanism.

    abstract:OBJECTIVE:This study was conducted to categorize barefoot stubbing injuries to the great toe in children by injury mechanism to differentiate benign stubbing injuries from more complex injuries necessitating surgery. DESIGN:Prospective clinical series of consecutively treated patients. SETTING:Tertiary university hos...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31828e5d39

    authors: Park DY,Han KJ,Han SH,Cho JH

    更新日期:2013-11-01 00:00:00