Background: Femoral shaft fracture, in company with the development of morden society and the increase in means of transport, is increasing in the number of case and the complicated degree of injury. Objectives: 1. To note indication for interlocking intramedullary SIGN nailing in femoral shaft fracture in adult patients. 2. To assess result of interlocking intramedullary SIGN nailing in treatment of femoral shaft fracture in adult patients. Subjects and method: A prospective, descriptive study was conducted in the 40 patients between the ages of 17 and 80 who were dignosed femoral shaft fracture caused by injury and operated for bone union by interlocking intramedullary SIGN nailing at Viet Duc hospital, from April/2004 to July/2005. Results: In this study: 5 patients with I degree fracture (12.5%), 20 with II degree (25%) and most of patients with III and IV degree fracture (62.5%), of which 14 patients with IV degree (35%). Because the SIGN nailing\u2019s structure was solid, so it had a good capacity for patient\u2019s weight. 4 weeks after operation, 85% patients were able to move around without crutches. There was no complications. Conclusion: SIGN nailing enables surgeons to drive interlocking intramedullary nailing for long bone without image intensifier. It also enables both surgeons and patients to appoarch modern, high effective methods without needing expensive machines.
Femoral Fractures/ surgery ; therapy ; Adult

External Fixators ; Female ; Femoral Fractures - diagnostic imaging Femoral Fractures - surgery ; Femoral Fractures - therapy ; Fracture Fixation, Internal - methods ; Fracture Fixation, Intramedullary - methods ; Fracture Healing - physiology

Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a balcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2), right distal metaphysis of the tibia and fibula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fluids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open reduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily activities comfortably. We also proposed the unique mechanism of injury in this report.
Accidental Falls ; Femoral Fractures ; therapy ; Fibula ; injuries ; Fracture Fixation ; methods ; Humans ; Infant ; Male ; Multiple Trauma ; Tibial Fractures ; therapy

Adult ; Femoral Neck Fractures ; etiology ; Humans ; Lymphangiectasis, Intestinal ; complications ; therapy ; Male

OBJECTIVETo compare clinical effects between Pavlik harness and Bryant traction in treating femoral shaft fractures in infants,including the time of hospitalization, expense of treatment, complications,time of bone union.

METHODSFrom May 2005 to August 2010,the clinical data of 42 infants with femoral shaft fractures were retrospectively analyzed. Among the patients, 23 cases were treated with Pavlik harness(Pavlik harness group),there were 14 males and 9 females,ranging in age from 1 to 12 months with an average of (5.5+/-2.4) months,including upper 1/3 segment of 16 cases and middle segment of 7 cases; transverse fracture of 18 cases and oblique fracture of 5 cases. The other 19 patients were treated with Bryant traction (Bryant traction group),there were 15 males and 4 females,ranging in age from 2 to 12 months with an average of (6.7+/-2.8) months,including upper 1/3 segment of 13 cases and middle segment of 6 cases;transverse fracture of 12 cases and oblique fracture of 7 cases. The time of hospitalization,expense of treatment,complications,time of bone union were analyzed in the patients.

RESULTSAll patients were followed up with an average of 25.3 months (ranging from 19 to 30) in Pavlik harness group and 23.7 months (ranging from 17 to 28) in Bryant traction group. Time of hospitalization, expense of treatment in Pavlik harness group were respectively (0.4+/-0.7) d, (2147.7+/-64.9) yuan; and in Bryant traction group were respectively(27.1+/-2.2) d, (2741.3+/-227.6) yuan;there was significant difference between two groups(P<0.05). No complication was found in Pavlik harness group and 8 cases complicated with skin hydroa in Bryant traction group, there was significant difference between two groups (P<0.05). Time of bone union,difference of both lower extremities in Pavlik harness group were respectively (4.1+/-0.3)weeks, (6.3+/-4.1) mm;and in Bryant traction group were respectively (3.9+/-0.3) weeks, (7.6 +/-4.3) mm; 20 cases got bone healing in Pavlik harness group and 18 cases got bone healing in Bryant traction group;there was no significant difference between two groups (P>0.05).

CONCLUSIONCompared with Bryant traction method,Pavlik harness method has obvious advantages in time of hospitalization, expense of treatment, complications in treating femoral shaft fractures in infants.

Female ; Femoral Fractures ; therapy ; Humans ; Infant ; Male ; Orthotic Devices ; adverse effects ; Traction ; adverse effects ; methods

Hoffa's fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa's fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa's fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa's fracture in a 16-year-old girl with asso ciated ipsilateral fibular fracture.
Adolescent ; Female ; Femoral Fractures ; diagnostic imaging ; therapy ; Fibula ; injuries ; Humans ; Knee Joint ; diagnostic imaging

Deep venous thrombosis (DVT) is an important cause of disability and mortality after major orthopedic surgery. The roles of perioperative treatment and prevention of DVT in patients with femoral neck fractures who require major surgery have not yet been well explored in Chinese clinical practice. Here we report a case of calf muscular venous thrombosis in a 55-year-old woman with femoral neck fracture before surgery. Preventive and treatment measures including the administration of heparin sodium, application of venous foot pump and placement of inferior vena cava filter were taken. The condition of the patient was stable during the perioperative period and the surgery was successful. Besides, postoperative examination showed that the femur healed well and the functional recovery was satisfactory. Our results suggest that femoral neck fracture patients combined with DVT can receive surgery after accurate preoperative assessment and proper preoperative treatment.
Female ; Femoral Neck Fractures ; surgery ; Humans ; Middle Aged ; Perioperative Care ; Vena Cava Filters ; Venous Thrombosis ; therapy

Dynamic hip screw fixation is a commonly performed procedure for internal fixation of intertrochanteric femoral fractures. Arterial injury following the operative fixation is a rare but serious event. We present a patient who developed pseudoaneurysm of profunda femoris artery after internal fixation of intertrochanteric fracture with a dynamic hip screw. The diagnosis was confirmed by angiographic study and it was successfully treated by coil embolization.
Accidental Falls ; Aged ; Aneurysm, False ; diagnostic imaging ; etiology ; therapy ; Angiography ; Bone Screws ; Embolization, Therapeutic ; Female ; Femoral Artery ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Postoperative Complications ; diagnosis ; etiology ; therapy

Adolescent ; Adult ; Aged ; China ; Female ; Femoral Neck Fractures ; therapy ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Young Adult

Intramedullary interlocking nailing is the gold standard for treatment of tibial shaft fractures. The growing use of intramedullary nailing has resulted in an increased number of tibial nailing in daily clinical practice. Despite adequate surgeon experience, tibial nailing is not without complications if proper techniques are not followed. A case of iatrogenic talar neck and medial malleolus fractures during intramedullary nailing of tibia in a 24-year-old male is reported. It is believed to be caused by forceful hammering of insertion zig with foot dorsiflexed. To the best of our knowledge, no such case has been reported in the literature. It is possible to reduce the risk of this complication by adoption of preventive measures.
Ankle Fractures ; Bone Nails ; adverse effects ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; adverse effects ; instrumentation ; Fractures, Bone ; diagnosis ; etiology ; therapy ; Humans ; Iatrogenic Disease ; Male ; Talus ; injuries ; Tibial Fractures ; surgery ; Tomography, X-Ray Computed ; Young Adult