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OTA e-Poster 2001: An Anatomic Study. Identifies optimal point for retrograde insertion as 7mm anterior to PCL attachment and 3.5mm medial to the center of the intercondylar groove

OTA Poster 2004: This study evaluated how inaccurate distal-screw targeting affects the fatigue strength of titanium alloy tibial nails.
0.0025 in. of interference results in a reduction of fatigue strength by 30%

Medscape Conference Coverage from Orthopaedic Trauma Association 16th Annual Meeting, October 12 - 14, 2000, San Antonio, Texas.
topics of discussion at the Orthopaedic Trauma Association 16th Annual Meeting associated with femoral fracture management included:
* How much bone loss can be tolerated in open femoral fractures treated with intramedullary nailing,...

OTA Poster 2004: The purpose of this study was to document the hip abductor muscle strength following standard antegrade intramedullary nailing by using two different objective measures
Conclusions: Antegrade reamed interlocking intramedullary nailing of femoral shaft fractures through a standard piriformis fossa starting point is not associated with any significant...

OTA paper 1998: This study examines the effects of retrograde femoral nail insertion on the biomechanics of the patello-femoral joint.

OTA Paper 2001: Purpose: We developed a new percutaneous insertion technique for antegrade femoral nailing and evaluated its efficacy and complication rate.

OTA Paper 1998: This study was undertaken to determine if intramedullary femoral nailing produces immediate worsening of pulmonary gas exchange in patients with femoral shaft fractures.
Conclusion: The process of femoral nailing with and without reaming does not appear to produce significant pulmonary marrow element emboli to alter pulmonary gas exchange,...

OTA Paper 2004: We sought to quantify the inflammatory response to initial surgery and conversion and link this to subsequent organ dysfunction and complications.

OTA Paper 1998:The purpose of this study was to examine fracture reduction after intramedullary nailing of femoral shaft fractures and to compare results of antegrade versus retrograde techniques.

Subtrochanteric Femoral fractures: OTA Basic Fracture Course Expert

Mechanism: axial load to a flexed knee;
- Bimodal distribution:
- low energy fractures involving older females (often these patients have severe osteoporosis);
- high energy fractures involving younger males;
- associated injuries:
- vascular Injury: 2-3% (similar to vessel injury in knee dislocations)
...

The decision is between a condylar buttress plate versus a 95 degree fixed angle device such as a blade plate or a DCS condylar screw. Biomechanically, the results are better with a fixed angle device.
OTA Basic Fracture Course Expert

OTA Basic Fracture Course The incidence of supracondylar fractures is 4 to 7% of all femur fractures. There is a somewhat bimodal distribution of these injuries. Expert

OTA paper 1998: To determine if alveolar dead space fraction (Vd/Vt) predicts postoperative pulmonary dysfunction in patients undergoing intramedullary nailing (IMN) of femoral shaft fractures (FSF).

OTA paper 2004:We report the nature of the early stress response in an ovine model of high-energy injury which more closely replicates the clinical situation of major trauma. Our hypothesis was that the immediate stress response to trauma is characteristic, and its magnitude is governed by the initial injury and...