Makale Arama

Aim: Distal femoral fractures are common seen both elderly and young population. These fractures are % 7 of all femoral fractures. Providing of alingment after distal femoral diaphyseal fractures is important for the development of deformity and shortness. In this study, it was aimed to determine whether the effect of intramedullary nail method applied in the treatment of distal femoral diaphyseal fractures that do not extend into the joint to the femoral alignment. Patients and Methods : 62 patients were evaluated who were treated with intramedullary nail with the diagnosis of distal femoral diaphyseal fracture between 2010 and 2016. Patients has at least 1 year of follow-up. Patients were divided into 3 groups according to fracture joint distance (<100 mm, 100-130 mm, >130 mm). Nail-joint distance (NJD), fracture line-joint distance (FJD), fracture-nail distance (FND), and the translation and alignment of the fracture line were evaluated for each group. Results: In group 1; NJD 17,1±6,8 mm, FJD 78,4±17,6 mm, FND 60,8±15,9 mm, translation 4±1,3 mm, and the malalignment was 2,9±1,7°. In Group 2; NJD 19±6,8 mm, FJD 119,5±8 mm, FND 100,6±8 mm, translation 3,9±1,7 mm, and malalignment 3±1,7°. In group 3; NJD 25,2±8,7 mm, FJD 143,3±7,8 mm, FND 118,1±11,7 mm, translation 3,5±1,8 mm, and malalignment was 2,5±1,4°. Conclusion: In our study, we found that as the distance between the fracture and the joint decreased, the degree of malalignment and translation increased, and when the distance between the nail and the joint was kept below 20 mm, the amount of malalignment and translation decreased. If distal femur fractures near the joint line will be treated with intramedullary nailing attention must be taken for the malalignment and translation. Especially when the fracture-joint distance is less than 100 mm, keeping the distance between the nail and the joint below 20 mm will keep the translation and malalingment at a minimum level.

Femoral shaft fractures are mostly seen in children and all cases of this condition require hospital admission. In school-age children (5 to 12 years), femoral fractures may be treated with elastic nails or spica cast. The current study aims to compare the outcomes of elastic nail to the immediate spica cast method for school-age children with femoral fracture. We evaluated the patients who had undergone immediate hip spica cast (IHSC as Group 1; n=31) or flexible intramedullary titanium nail (FITN as Group 2; n=31) for femoral fracture. Age, sex, cause of fracture, localization of the fracture, cost of treatment, times of hospitalization, radiologic and clinical assessment of femoral union, condition of the wound and soft tissue, times of union and walking were recorded. The mean followup was 58 (26-62) months. All fractures were healed. The time for weight-bearing and walking were shorter (39/52) in Group 2 than it was in Group 1 (52/63). In terms of cost, IHSC (114.99$) was cheaper than FITN (380.82$). Although IHSC is still a a widely accepted method of treatment, with the use of modern surgical techniques and implants, satisfactory outcomes of fracture healing can make FITN a better surgical option among all other treatments.

Postoperative heterotopic ossification (HO) around the hip is common follovving total hip arthroplasty and after surgical treatment of the acetabular fractures. Hovvever, its occuring after intramedullary nailing operations for femoral fractures is relatively uncommon and not well documented. The purpose of this study was to evaluate the clinical importance and aspects of heterotopic ossification after intramedullary nailing. Between October 1995 and March 1999, 70 patients treated by intramedullary femoral locked and reamed femoral nailing were follovved and studied, prospectively. There were 63 male and 7 female and average age was 34 years (17 to 70). To determine of HO, the criteria described by Brumback et al. were used. Mean follow-up was 18 months (9 to 48 months). Ten patients were lost to follovvup, thus 60 patients remained were evaluated. Grade I HO developed in 4 patients (7%), grade II in 1 patient (1.5%) and grade III in 1 patient (1.5%). The patients who developed HO were treated by conservative methods with success. İn conclusion, the findings of this study support that heterotopic ossification after intramedullary femoral nailing is uncommon and not a great problem in management of this patients.