Actual problems of using intramedullary blocked osteosynthesis for open fractures of the shinbones and femoral bones in patients with combined injuries are considered. The most optimal terms of operative treatment were established depending on the severity of the injuries by ISS scale and on classification of injuries of the soft tissues by Gastillo-Andersen. The schemes of antibacterial prophylactics of infectious complications are proposed both during operation and at the postoperative period. Under consideration are the questions of intraoperative boring of the bone marrow canal of the shinbones and femoral bones in severe combined injuries.
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Comparison of Efficacy of Suprapatellar and Infrapatellar Approaches for Intramedullary Interlocking Nailing of Tibia in Patients With Tibial Fracture.
Cureus
November 2024
Information Technology, Mandayam Osuri Parthasarathi Vaishnav College for Women, Chennai, IND.
Introduction: Intramedullary interlocking nailing is a common surgical procedure for tibial fractures, enabling early patient mobilization. Traditionally, the infrapatellar approach has been used for intramedullary interlocking nailing of tibial fractures, but the suprapatellar approach is gaining attention for its potential benefits. This randomized controlled study aimed to compare the duration of the surgery, intra-operative blood loss, and fluoroscopy time between the suprapatellar and infrapatellar approaches.
View Article and Find Full Text PDFComparison of the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in the treatment of tibial metaphyseal-diaphyseal junction fractures.
J Orthop Surg Res
December 2024
Department of Clinical Laboratory, Shengli Oilfield Central Hospital, No. 31 Jinan Road, Dongying, Shandong, 257034, China.
Background: To compare the efficacy of intramedullary nailing via the lateral parapatellar approach versus the infrapatellar approach in treating fractures at the tibial metaphyseal-diaphyseal junction.
Methods: A retrospective analysis was conducted on the clinical data of 45 patients with proximal or distal tibial fractures treated with intramedullary nailing via lateral parapatellar approach (n = 23) or infrapatellar approach (n = 22) between January 2019 and March 2023. We recorded and compared the operative time, intraoperative blood loss/fluoroscopies, success rate of closed reduction, anteroposterior and lateral entry point accuracy, postoperative infection, fracture healing time, as well as NRS pain scores, Lysholm knee function scores, and knee range of motion.
Refined Techniques in Tibial Nailing.
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November 2024
From the Department of Orthopedic Trauma, Harris Methodist Fort Worth Hospital, Fort Worth, TX (Collinge), and the Department of Orthopedic Trauma, Vanderbilt University Medical Center, Nashville, TN (Dr. Rickert, Dr. Mitchell, and Dr. Boyce).
Intramedullary nail fixation of unstable tibial diaphyseal fractures is commonly used with excellent clinical results. Indications for nailing have rapidly expanded over recent years, allowing for more difficult fractures to be addressed with "extreme nailing." Despite its widespread use, evolution of newer nailing systems and varying techniques for insertion bring new difficulties with tibial fracture reduction, and malalignment occurs with relative frequency.
View Article and Find Full Text PDFThe effect of pericapsular nerve group (PENG) block on postoperative analgesia in elderly patients who underwent proximal femoral nail anti-rotation surgery: a prospective, randomized-controlled trial.
BMC Anesthesiol
November 2024
Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, No. 516, Jinrong South Road, Fuzhou, 350001, Fujian, China.
Article Synopsis
- The study investigates the effectiveness and safety of the peri-capsular nerve group (PENG) block as a pain management technique for elderly patients with intertrochanteric femur fractures undergoing surgery.
- A randomized controlled trial was conducted with 110 patients to compare cumulative sufentanil consumption between the PENG block and a conventional opioid-based program during the first 48 hours post-surgery.
- Results showed that the PENG block group had significantly lower opioid usage and better pain scores compared to the control group, suggesting it could be a valuable addition to post-operative care for this demographic.
Dual-channel minimally invasive percutaneous cerclage for femoral shaft and metaphysis fractures during the internal fixation with intramedullary nails: case reports and technical description.
Quant Imaging Med Surg
October 2024
Department of Orthopedics, Zibo Municipal Hospital, Zibo, China.
When treating femoral fractures with closed reduction intramedullary nail fixation, excessive residual displacement of the fracture end can affect the fixation effect and prolong the healing time, which is difficult to manage intraoperatively. This article introduces a simple steel wire cerclage fixation technique, which is percutaneous and can control the incision within 1 cm without excessive reliance on specially designed surgical instruments. It is suitable for the reduction and fixation of oblique femoral metaphysis fractures and butterfly-shaped femoral shaft fracture blocks.
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