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Related Experiment Videos

[Indications for the interlocking nailing in open fractures].

H Kohlmann1, V Vecsei, K Rabitsch

  • 1Wilhelminenspital der Stadt Wien, 1. Chirurgische Abteilung mit Unfallabteilung.

Aktuelle Traumatologie
|April 1, 1988
PubMed
Summary

Septic complications from intramedullary nailing of open fractures are mainly due to reaming, not locking nailing. Femur fractures can use locking nails if soft tissue coverage is adequate, but lower leg fractures require external fixation for severe injuries.

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Area of Science:

  • Orthopedic surgery
  • Trauma management

Context:

  • Open fractures present significant challenges in orthopedic treatment.
  • Intramedullary nailing has evolved, with reaming and locking techniques impacting outcomes.
  • Septic complications remain a concern in managing these injuries.

Purpose:

  • To evaluate the role of locking intramedullary nailing in treating open femur and lower leg fractures.
  • To differentiate the risks associated with reaming versus locking nailing in septic complications.
  • To establish treatment guidelines based on fracture severity and location.

Summary:

  • Septic complications in open fractures treated with intramedullary nailing are primarily linked to the reaming process, rather than the locking nailing technique itself.
  • Locking intramedullary nailing is suitable for open femur fractures (all degrees) provided adequate soft tissue coverage and minimal periosteal exposure.

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  • For open lower leg fractures, locking nailing is only recommended for Type I injuries; Types II and III necessitate the use of external fixation.

    • Impact:

    • Refines treatment protocols for open fractures, potentially reducing septic complications.
    • Highlights the importance of surgical technique (reaming vs. locking) in preventing infection.
    • Provides clear guidance on implant selection (intramedullary nail vs. external fixator) based on fracture classification and location.