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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner

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Rigid Intramedullary Nailing of Femoral Shaft Fractures in Skeletally Immature Patients Using a Lateral Trochanteric

Elliott J Kim1, Samuel N Crosby1, Gregory A Mencio1

  • 1Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital, 4202 DOT, 2200 Children's Way, Nashville, TN 37232-9565. E-mail address for J.E. Martus: jeff.martus@vanderbilt.edu.

JBJS Essential Surgical Techniques
|February 19, 2019
PubMed

Insights

This study details rigid intramedullary nailing with trochanteric entry for pediatric femoral shaft fractures. This technique offers effective internal fixation for skeletally immature patients.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Trauma Surgery

Background:

  • Femoral shaft fractures are common in children and adolescents.
  • Internal fixation is a standard treatment for these fractures.
  • Rigid intramedullary nailing provides a stable construct for fracture healing.

Purpose of the Study:

  • To describe the technique of rigid intramedullary nailing using a trochanteric entry for femoral shaft fractures in skeletally immature patients.
  • To outline the key steps and considerations for successful surgical intervention.
  • To review outcomes in a cohort of pediatric patients.

Main Methods:

  • Retrospective review of 241 skeletally immature patients with 246 femoral shaft fractures.
  • Surgical technique involves trochanteric entry rigid intramedullary nailing.
  • Detailed description of surgical steps including preparation, incision, guidewire placement, reaming, nail insertion, and interlocking screw fixation.

Main Results:

  • A cohort of 246 femoral shaft fractures was treated.
  • Patients were skeletally immature.
  • The study reviewed indications, contraindications, pitfalls, and challenges associated with the procedure.

Conclusions:

  • Rigid intramedullary nailing with trochanteric entry is a viable surgical option for femoral shaft fractures in older children and adolescents.
  • Meticulous surgical technique and preparation are crucial for minimizing complications.
  • Further studies may be warranted to evaluate long-term outcomes and compare with other fixation methods.
Abstract

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