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Strategies in Trauma and Limb Reconstruction

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Open Access 01-12-2009 | Original Article

The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

Authors: Efthimios J. Karadimas, George Papadimitriou, Gerasimos Theodoratos, Anastasios Papanikolaou, John Maris

Published in: Strategies in Trauma and Limb Reconstruction | Issue 3/2009

Abstract

This retrospective study presents the experience gained through use of reamed femoral nails and reports results and respective complications. This study included 415 femur fractures (312 men and 101 women with a mean age of 27.8 years) that were treated from 1993 to 2004. The fractures were classified according to AO, and 74 open fractures were included and typed according to the Gustilo classification. Dynamic nailing was performed for nearly all type A fractures and static nailing for types B and C. After a mean follow-up of 1.5 years, union rate was 97.8%. The complications were: 9 non-unions, 14 delayed-unions, 4 torsional malunions, 6 limb length discrepancies (shortening) and 30 nerve pareses due to traction. Deep venous thrombosis (DVT) occurred below the knee in 4 patients, while there were recorded 3 pulmonary and 2 fat embolisms, 1 superficial and 1 deep infection. There were 28 broken screws identified postoperatively. Logistic regression analysis revealed that type B and C were associated with increased risk of complications, with respective odds ratios of 3.1 (95% CI = 1.3–7.2, P = 0.011) and 4.3 (95% CI = 1.8–10.3, P = 0.001) when compared to type A patterns. All patients returned to their activities in a mean time of 10 months. Intramedullary nailing is still the treatment of choice for femoral shaft fractures, but knowledge of potential complications and their association with certain fracture patterns is needed.

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Title: The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures
Authors: Efthimios J. Karadimas
George Papadimitriou
Gerasimos Theodoratos
Anastasios Papanikolaou
John Maris
Publication date: 01-12-2009
Publisher: Springer Milan
Published in: Strategies in Trauma and Limb Reconstruction / Issue 3/2009
Print ISSN: 1828-8936
Electronic ISSN: 1828-8928
DOI: https://doi.org/10.1007/s11751-009-0071-2

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The effectiveness of the antegrade reamed technique: the experience and complications from 415 traumatic femoral shaft fractures

Abstract

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