Flores VVM, Hernández SA, Casas MG, Sotelo MMA

Language: Spanish
References: 12
Page: 226-230
PDF size: 50.34 Kb.

ABSTRACT

Introduction. In some Hansen-Winquist type III and IV closed femoral shaft fractures satisfactory closed reduction can’t be achieved. This drives the surgeon to the dilemma of doing and open reduction or to preserve the haematoma and stabilize the fracture even if there is no total contact between the bone fragments. Material and methods. A case control study was done in patients with Hansen-Winquist type III and IV closed femoral shaft fractures treated with closed interlocked intramedullary nails. Case group: patients with an unsatisfactory fracture reduction. Control group: patients with satisfactory fracture reduction, matched by type of fracture and treatment device. Student t test was used in the evaluation of age, time of union, complications and knee movement. Results. Ten patients with unsatisfactory femoral shaft fracture reduction (case group) were compared against ten patients with satisfactory reduction (control group). Case group: mean age 20.2 years, 6 with type III fracture 4 with type IV, mean union time 124 days. Two nonunions and two knee joint stiffness. Control group: mean age 24.8 years, mean union time 115 days. Two nonunions, knee joint stiffness in three cases. There were no transoperative or postoperative complications in both groups. There were no statistical significative differences in union time, and nonunion. There were significative differences in age and knee joint mobility. Discussion. A 20% incidence of nonunion is higher than the reported in the reviewed articles, we must consider that none of them deals only with comminuted or segmentary fractures. The reason of the absence of transoperative and postoperative complications and mortality may be the younger age of the patients and the absence of comorbility. Mean bone union time is similar to those described in other series. Conclusions. Bone union time and non union were similar in both groups.

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