Journals / Journal of Health Sciences and Medicine / 2023 / Cilt: 6 Sayı: 2

Which of the three different intramedullary nail designs is superior in the treatment of femoral shaft fractures?

Pages
467–475
Publication Date
2023-03-27
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This showed that all three nails did not have a significant advantage over each other in providing fracture stability.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The aim of this study a retrospective comparison was the clinical and radiological results results of patients with femoral shaft fracture made oftreated with three different types of intramedullary nail (IMN).
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Key Findings & Data:Material and Method: The study included 54 patients operated on in our clinic because of femoral shaft fracture.
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Conclusion & Impact:This showed that all three nails did not have a significant advantage over each other in providing fracture stability.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Femoral shaft fracture · intramedullary nail · distal hook

Abstract

Aim: The aim of this study a retrospective comparison was the clinical and radiological results results of patients with femoral shaft fracture made oftreated with three different types of intramedullary nail (IMN). Material and Method: The study included 54 patients operated on in our clinic because of femoral shaft fracture. The records were retrospectively examined of 18 patients applied with locked IMN (LIMN), 17 with blade expandable IMN (BEIMN), and 19 with talon distalfix IMN (TDIMN). The groups were compared statistically in respect of age, gender, BMI, affected side, operating time (mins), radiation exposure (number of shots), time to union (weeks), visual analog scale (VAS) score, soft tissue problems associated with implant irritation, amount of shortening (mm), coronal, sagittal and torsional angulation (degrees). Results: The mean VAS score of the TDIMN group was determined to be statistically significantly higher than that of the LIMN and BEIMN groups (p=0.008, p=0.045). The operating times were similar in the BEIN and TDIMN groups (p=0.768) and significantly shorter than in the LIMN group (p<0.001). Radiation exposure was similar in the TDIMN and BEIMN groups (p=0.039), and the number of shots in the LIMN group was significantly higher than in the other two groups (p<0.001). The coronal angulation values were lower in the TDIMN group than in the BEIMN and LIMN groups (p=0.001, p=0.020). The sagittal angulation values were lower in the TDIMN group than in the BEIMN and LIMN groups (p=0.001, p<0.001). No significant difference was determined between the groups in respect of time to union, limb shortness, rotational deformity, and soft tissue problems related to implant irritation (p>0.05). Conclusion: TDIMN is less resistant to axial loads due to its hook structure design. In fact, this is sometimes seen as a hook break. High VAS scores explain this. The sagittal and coronal angulation of the TDIMN is less, but the time to union, rotational angulation, and shortness development are similar in all three nails. This showed that all three nails did not have a significant advantage over each other in providing fracture stability.

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Cite This Article

ALIÇ, T., GÜLER, C., ÇALBIYIK, M., HASSA, E. (2023). Which of the three different intramedullary nail designs is superior in the treatment of femoral shaft fractures?. Journal of Health Sciences and Medicine, Cilt: 6 Sayı: 2, 467–475. https://ajindex.com/articles/907868

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References (13)

  1. Rosa N, Marta M, Vaz M, et al. Recent developments on intramedullary nailing: a biomechanical perspective. Ann N Y Acad Sci 2017; 1408: 20-31. Wood GW. Intramedullary nailing of femoral and tibial shaft fractures. J Orthop Sci 2006; 11: 657-69.
  2. Sipahioglu S, Zehir S, Sarikaya B, Isikan UE. Comparision of the expandable nail with locked nail in the treatment of closed diaphyseal fractures of femur. Niger J Clin Pract 2017; 20: 792-8.
  3. Pourmokhtari, M. Principles of fixation with ınterlocking nailing. Iranian Journal of Orthopaedic Surgery Summer 2018; 16: 265-72.
  4. Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of the lower extremity: biomechanics and biology. J Am Acad Orthop Surg 2007; 15: 97-106.
  5. Basaran T, Calbiyik M, Basaran PÖ, Hassa, E, Ipek D. Blade expandable intramedullary nails for fixation of tibial shaft fractures. Acta Orthop Belg 2019; 85: 472-6.
  6. Çamurcu Y, Sofu H, Issın A, Koçkara N, Genç E, Çetinkaya M. Is talon tibial intramedullary nailing clinically superior compared to conventional locked nailing? Jt Dis Relat Surg 2017; 28: 152-7.
  7. Bekmezci T, Baca E, Kaynak H, Kocabaş R, Tonbul M, Yalaman O. Early results of treatment with expandable intramedullary nails in femur shaft fractures. Acta Orthop Traumatol Turc 2006;40: 1-5.
  8. Whelan DB, Bhandari M, Stephen D, et al. Development of the radiographic unionscore for tibial fractures for the assessmentof tibial fracture healing after intramedullary fixation. J Trauma 2010; 68: 629-32.
  9. Litrenta J, Tornetta P, Mehta S, et al. Determination of radiographic healing: an assessment of consistency using RUST and modified RUST in metadiaphyseal fractures. J Orthop Trauma 2015; 29: 516-20.
  10. Samiezadeh S, Avval PT, Fawaz Z, Bougherara H. Biomechanical assessment of composite versus metallic intramedullary nailing system in femoral shaft fractures: a finite element study. Clin Biomech 2014; 29: 803-10.
  11. Clatworthy MG, Clark DI, Gray DH, Hardy AE. Reamed versus unreamed femoral nails. a randomised prospective trial. J Bone Joint Surg Br 1998; 80: 485-9.
  12. Rosa N, Marta M, Vaz M, et al. Intramedullary nailing biomechanics: evolution and challenges. Proc Inst Mech Eng H 2019; 233: 295-308.
  13. Letechipia J, Alessi A, Rodrı´guez G, Asbun J. Design and preliminary testing of an active intramedullary nail. Clin Transl Invest 2014; 66: 70-8. Ligier JN. Biomechanics of FIN. In Flexible Intramedullary Nailing in Children: The Nancy University Manual. P. Lascombes, Ed. Berlin: Springer-Verlag; 2009; 19-24. Rosa N