OWL: OCOSH Classification/Trauma/Fractures/Femur Fractures/Femoral Shaft Fractures

Avoiding Missed Femoral Neck Fractures

Tournetta et al — 2005-09-05 23:20:13 GMT

OTA paper 2004: Improvement by Using a Standard Protocol in Cases of Femoral Shaft Fractures:
The purpose of this study was to describe a program of quality improvement and a subsequent protocol that have resulted in a reduction of missed femoral neck fractures in patients with femoral shaft fractures

1983 The influence on the spine of leg-length discrepancy after femoral fracture

Gibson et al — 2007-07-21 23:20:13 GMT

J Bone Joint Surg Br. 1983 Nov;65(5):584-7. The influence on the spine of leg-length discrepancy after femoral fracture.Gibson PH, Papaioannou T, Kenwright J.
We investigated the spines of 15 patients who had significant leg-length inequality as a result of femoral shaft fractures sustained after skeletal maturity but below the age of 21 years. The patients were examined at least 10 years after fracture. The spines were studied clinically and radiographically before and after correction of leg-length inequality with a shoe-raise. Lateral spinal flexion was measured from radiographs. The lumbar scoliosis associated with the leg-length inequality was compensatory: after equalisation of leg-length the overall curve and the axial rotation were corrected completely. There was also an equal range of lateral flexion to either side after correction. Minor malalignments of the whole spine remained despite correction of the compensatory scoliosis, and within the lumbar spine correction of the scoliosis had not occurred equally at all levels. No patients complained of significant discomfort and neither structural abnormalities nor degenerative changes were seen on the radiographs.

1999 Results Of Treatment Of 111 Patients With Nonunion Of Femoral Shaft Fractures

Bereddjiklian et al — 2006-04-10 23:20:13 GMT

P. K. Beredjiklian, M.D., R. J. Naranja, M.D., R. B. Heppenstall, M.D., C. T. Brighton, M.D., Ph.D., and J. L. Esterhai, M.D.
Abstract: The purpose of this study is to report our experience with the treatment of femoral shaft fracture nonunion and to define poor prognostic indicators in the treatment of this complication. The records and available radiographs of 111 patients treated for nonunion of the femoral shaft in our institution were retrospectively reviewed. The mean duration of follow-up after establishment of nonunion was 62 months. The following factors were found to have an adverse effect on nonunion healing (p < 0.05): (1) advanced patient age; (2) presence of osteomyelitis; (3) presence of synovial pseudarthrosis; (4) duration of nonunion; (5) treatment with flexible intramedullary devices; (6) treatment with compression plating; (7) poor bone stock; (8) malalignment in the anteroposterior plane of more than 10 degrees; and (9) malalignment in the lateral plane of more than 20 degrees. (Full Text article)

A New Biological Method Of Internal Fixation Of The Femur

Milorad Mitkovic — 2006-04-13 23:20:13 GMT

Mitkovic 2001 Facta Universitatis Vol. 8, No 1, 2001 pp. 50 - 53 Abstract -> Full Text
New internal fixator that provides fixation while application can be performed by minimally invasive method with no contact between the implant and bone fragment in fracture area. The device is selfdynamisible.

A Prospective Comparison of Antegrade and Retrograde Femoral Intramedullary Nailing

Ostrum et al — 2005-09-04 23:20:13 GMT

OTA Paper 1998 Robert F. Ostrum, MD; Animesh Agarwal, MD; Ronald Lakatos, MD; Attila Poka, MD
The purpose of this study was to prospectively and critically examine a consecutive series of femur fractures treated with either antegrade or retrograde intramedullary nailing.

A Prospective Evaluation of Hip Abductor Function after Femur Fracture and Antegrade Nailing

Archdeacon et al — 2005-09-05 23:20:13 GMT

OTA Paper 2004 Archdeacon et al
The purpose of this study was to prospectively analyze hip abductor function at two discrete time points after a femur fracture treated with intramedullary nailing.

A Prospective RCT Comparing Reamed versus Unreamed Intramedullary Nailing of Femoral Shaft Fractures

DeGroote et al — 2005-09-04 23:20:13 GMT

OTA paper 1998 Randomized Clinical Trial: The objective of this clinical trial was to determine if the type of intramedullary nail fixation (IMN) in acute femoral shaft fractures affects pulmonary function.

Accelerated Bone Healing in Patients with Femoral Fracture and Head Injury

Mushtaq et al — 2005-09-05 23:20:13 GMT

OTA paper 2004: We investigated whether the presence of head injury is associated with accelerated bone healing in patients with femoral shaft fractures.

Anterograde vs Retrograde Femoral Nailing

Tournetta et al — 2005-09-05 23:20:13 GMT

OTA paper 2004: A Prospective Randomized Evaluation: Purpose: We compared anterograde with retrograde nailing of isolated femoral shaft fractures.
Conclusions: Anterograde and retrograde nailing are both acceptable treatments for femoral shaft fractures.

AO Classification of Femoral Diaphyseal Fractures

Not Available — 2002-02-04 23:20:13 GMT

AO Classification of Femoral Shaft Fractures

Bilateral Femur Fractures

Veillette — 2006-04-11 23:20:13 GMT

This 82 year old lady slipped and fell while she was pushing her shopping cart across an icy parking lot. She was unable to get up from her fall and was taken to hospital. In the emergency room, she complained of pain in both legs. She was neurovascularly intact, had deformities of both thighs, and there were no open injuries. Examination of both hips, ankles, and feet were normal. The pelvis was stable and nontender. Radiographs were obtained after splinting her legs (below).

Comminuted Femur Fracture

Alex Chelnokov — 2006-04-11 23:20:13 GMT

OTA Case discussion A male 31 y.o. addmitted to our unit today with the subject (see attachment). Injured in a car accident 1 month ago, since that he has been at bed traction. Other fractures are minor - undisplaced pubic rami and distal ulna.

Comminuted Lower-Extremity Fractures Secondary to Trauma

Not Available — 2005-09-04 23:20:13 GMT

Reports from Medscape Orthopaedics and Sports Medicine 1999
Ipsilateral femoral neck and shaft fractures
Fracture Healing in Tibia Fractures With an Associated Vascular Injury
The Treatment of Lisfranc Injuries
Open Fractures of the Patella: Long-term Functional Outcome

Conversion of External Fixation to Intramedullary Nailing for Femoral Shaft Fractures in Polytrauma

Nowotarski et al — 2005-09-04 23:20:13 GMT

OTA Paper 1998:
Purpose: To evaluate the safety and efficacy of this two-stage treatment, we retrospectively reviewed the records of 63 polytrauma patients with 69 femoral fractures treated with conversion of external fixation to IM nailing from 1989 to 1997 at our institution.

Diaphyseal Femur Fractures eMedicine Orthopedics

Eastwood & Biggs — 2005-09-04 23:20:13 GMT

eMedicine article on diaphyseal femur fractures.
Orthopedic surgeons often encounter diaphyseal femur fractures. Because these fractures most often result from high-energy trauma, one must have a high index of suspension for complications or other injuries.
Eastwood & Biggs 2008 updated