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Background: To determine the clinical outcomes following fibula nail fixation and to identify the indication for the use of fibula nails in lower limb fractures.
Methods: Retrospective study of adult patients from 2 major trauma centers (MTCs) and 9 trauma units (TUs) who underwent fibula nail fixation for AO/OTA 44 fractures between January 1, 2018, and October 31, 2020. Outcome measures included infection, metalwork complications, nonunion or malunion, time to union, and length of inpatient hospital stay.
Results: Ninety-five patients were included, with a mean age of 66 years; 57.9% of patients were female. The average body mass index was 30. Sixty-nine patients (72.6%) sustained a Weber B and 24 (27.4%) sustained a Weber C fracture. In addition, 26.3% were open fractures and all patients had soft tissue compromise affecting the lateral malleolus. The calculated infection rate for fibula nail was 4.2% and metalwork complication rate was 5.2%. The nonunion and malunion rate was 8.4% and rate of removal of hardware was 2.1%. The average time to union was 12.5 weeks, and length of inpatient stay was 9.4 days (SD 10).
Conclusion: This multicenter study demonstrates that use of a fibula nail appears to be a safe approach to treating patients who have a physiologically higher risk of surgery, poor skin condition, and a complex fracture pattern.
Level Of Evidence: Level III, case-control study.
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http://dx.doi.org/10.1177/10711007211061401 | DOI Listing |
World J Surg Oncol
December 2024
Department of Orthopaedic Surgery, Sarcoma Unit, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
Background: Post-radiation fractures (PRF) are a recognised complication of radiation treatment for soft tissue sarcomas. They have a low incidence and typically occur up to 5 years following treatment, more commonly affecting the pelvis, ribs and femur. Due to radiation-induced changes in bone, PRFs typically require more complicated intervention compared to post-trauma fractures, however, limited literature exists, particularly in regards to mid-shaft femoral PRFs.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Orthopedics, Zhejiang Rongjun Hospital, Nanhu District, Jiaxing, Zhejiang, PR China.
Rationale: We first report a unique case of proximal femoral Giant cell tumor of bone, a subtrochanteric lesion associated with femoral neck and intertrochanteric involvement. We chose a completely new surgical approach to treat the primary tumor and preserve the hip joint. No cases of this type have ever been reported.
View Article and Find Full Text PDFJ Orthop Case Rep
December 2024
Department of Orthopaedic and Trauma Surgery, Hospital General Universitario Gregorio Marañon, C. Dr. Esquerdo 46, 28007, Madrid, Spain.
Introduction: Extra-articular deformity is that located proximal to the femoral epicondyles or distal to the neck of the fibula. In patients with gonarthrosis associated with extra-articular deformity, a different evaluation and approach will be necessary at the time of planning the arthroplasty. 3D planning and printing techniques have had a major impact on pre-operative planning, allowing the production of custom guides at low cost and in an accessible way.
View Article and Find Full Text PDFJ Orthop Case Rep
November 2024
Department of Orthopaedics, Maa Ram Pyari Ortho Centre, Ranchi, Jharkhand, India.
Introduction: Aseptic ulnar diaphyseal non-union presents a complex challenge in orthopedic practice, particularly when compounded by concurrent seizure disorders. This case report highlights the unique considerations and innovative approaches in managing such cases, emphasizing the importance of interdisciplinary collaboration and tailored treatment strategies.
Case Report: We present the case of a 35-year-old male with a history of recurrent ulnar fractures and generalized tonic-clonic seizures.
J Orthop Case Rep
November 2024
Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Introduction: Resistant and refractory non-union of distal tibia extra-articular fractures is very common even following internal fixation due to poor blood supply to the distal tibia metaphyseal region. The management can be challenging.
Case Report: A 50-year-old diabetic male had sustained closed distal tibia extra-articular fracture at the junction of diaphysis and metaphysis.
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