Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation
Background: Femoral shaft fractures result from high-energy trauma. Despite intramedullary nailing (IMN) representing the gold standard option of treatment, external fixation (EF) can be used temporarily for damage control or definitively. The purpose of this study is to compare two different option...
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doaj-66b7cc926abf401f92cf037bf2d3c1da2020-11-25T02:18:33ZengMDPI AGJournal of Clinical Medicine2077-03832019-07-0188111910.3390/jcm8081119jcm8081119Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External FixationGianluca Testa0Andrea Vescio1Domenico Costantino Aloj2Giacomo Papotto3Luigi Ferrarotto4Alessandro Massé5Giuseppe Sessa6Vito Pavone7Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyDepartment of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyDepartment of Orthopaedics Surgery, Division of Muscular-Skeletal Traumatology, AOU Città della Salute, CTO Hospital, 10126 Turin, ItalyDepartment of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyDepartment of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyDepartment of Orthopaedics Surgery, Division of Muscular-Skeletal Traumatology, AOU Città della Salute, CTO Hospital, 10126 Turin, ItalyDepartment of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyDepartment of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatologic Surgery, AOU Policlinico-Vittorio Emanuele, University of Catania, 95123 Catania, ItalyBackground: Femoral shaft fractures result from high-energy trauma. Despite intramedullary nailing (IMN) representing the gold standard option of treatment, external fixation (EF) can be used temporarily for damage control or definitively. The purpose of this study is to compare two different options, anterograde IMN and monoaxial EF, for the treatment of femoral shaft fractures. Methods: Between January 2005 and December 2014, patients with femoral shaft fractures operated on in two centers were retrospectively evaluated and divided into two groups: the IMN group (<i>n</i> = 74), and the EF group (<i>n</i> = 73). For each group, sex; laterality; age; and AO classification type mean follow-up, mean union time, and complications were reported. Results: Both groups were found to have no statistical differences (<i>p</i> > 0.05) in sex, laterality, age, and AO classification types. In the IMN group the average surgery duration was 79.7 minutes (range 45−130). The average time for bone union was 26.9 weeks. Major complications occurred in 4 (5.4%) patients. In the EF group the average follow-up duration was 59.8 months (range 28−160). The average time for bone union was 24.0 weeks. Major complications occurred in 16 (21.9%) patients. Conclusions: IMN is the gold standard for definitive treatment of femoral shaft fractures. In patients with severe associated injuries, EF should be a good alternative.https://www.mdpi.com/2077-0383/8/8/1119femoral shaft fracturespolytraumaanterograde intramedullary nailingmonoaxial external fixation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gianluca Testa Andrea Vescio Domenico Costantino Aloj Giacomo Papotto Luigi Ferrarotto Alessandro Massé Giuseppe Sessa Vito Pavone |
spellingShingle |
Gianluca Testa Andrea Vescio Domenico Costantino Aloj Giacomo Papotto Luigi Ferrarotto Alessandro Massé Giuseppe Sessa Vito Pavone Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation Journal of Clinical Medicine femoral shaft fractures polytrauma anterograde intramedullary nailing monoaxial external fixation |
author_facet |
Gianluca Testa Andrea Vescio Domenico Costantino Aloj Giacomo Papotto Luigi Ferrarotto Alessandro Massé Giuseppe Sessa Vito Pavone |
author_sort |
Gianluca Testa |
title |
Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation |
title_short |
Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation |
title_full |
Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation |
title_fullStr |
Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation |
title_full_unstemmed |
Definitive Treatment of Femoral Shaft Fractures: Comparison between Anterograde Intramedullary Nailing and Monoaxial External Fixation |
title_sort |
definitive treatment of femoral shaft fractures: comparison between anterograde intramedullary nailing and monoaxial external fixation |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2019-07-01 |
description |
Background: Femoral shaft fractures result from high-energy trauma. Despite intramedullary nailing (IMN) representing the gold standard option of treatment, external fixation (EF) can be used temporarily for damage control or definitively. The purpose of this study is to compare two different options, anterograde IMN and monoaxial EF, for the treatment of femoral shaft fractures. Methods: Between January 2005 and December 2014, patients with femoral shaft fractures operated on in two centers were retrospectively evaluated and divided into two groups: the IMN group (<i>n</i> = 74), and the EF group (<i>n</i> = 73). For each group, sex; laterality; age; and AO classification type mean follow-up, mean union time, and complications were reported. Results: Both groups were found to have no statistical differences (<i>p</i> > 0.05) in sex, laterality, age, and AO classification types. In the IMN group the average surgery duration was 79.7 minutes (range 45−130). The average time for bone union was 26.9 weeks. Major complications occurred in 4 (5.4%) patients. In the EF group the average follow-up duration was 59.8 months (range 28−160). The average time for bone union was 24.0 weeks. Major complications occurred in 16 (21.9%) patients. Conclusions: IMN is the gold standard for definitive treatment of femoral shaft fractures. In patients with severe associated injuries, EF should be a good alternative. |
topic |
femoral shaft fractures polytrauma anterograde intramedullary nailing monoaxial external fixation |
url |
https://www.mdpi.com/2077-0383/8/8/1119 |
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