Intramedullary is a form of The ability recovery is more surely in comparison with and reduce maximum infection ricks. The administration of Osteosynthesis with intramedullary nail by femoral nailing of Grosse and Kemf is broken of thigh from 1/3 high to 1/3 low, multi-bone broken. The administration of Osteosynthesis with intramedullary nail is
Fracture Fixation ; Intramedullary ; Fracture Fixation ; Internal ; Fractures ; Bone

OBJECTIVE: To evaluate the efficacy and safety of proximal femoral nail antirotation(PFNA) vs InterTAN nail in treating the elderly intertrochanteric femoral fractures. METHODS: Data of the randomized controlled trials(RCTs) about PFNA vs InterTAN for the treatment of the elderly intertrochanteric femoral fractures were searched in as the Cochrane Library, PubMed, EMbase, Wanfang, CNKI, CBM and VIP from their establishment to January 2018 for collecting. After study selection, assessment and data extraction conducted by two reviewers independently, meta-analyses were performed by using the RevMan 5.3 sofware. The level of evidence was assessed by using the GRADEpro system. RESULTS: Twelve studies involving 1 015 patients were included. The results of meta, analyses showed that: (1)safety indicator: compared with the InterTAN, PFNA had shorter operation time, and less intraoperative bleeding. But InterTAN had less total postoperative complications and internal fixation failure, but there was no significant difference in the operative incision lengths, fracture healing time and other postoperative complications. (2)efficacy indicator: compared with the InterTAN, the Harris hip score was lower after 3 months, but Harris hip score had no significant difference between the two groups after 6, 12 months. Based on GRADEpro system, all the evidence was at level C and weak recommendation(2C). CONCLUSIONS The current evidence indicates that PFNA had a similar effect compared with the InterTAN. But InterTAN could provide better stability against rotation and axial pressure effect, can allow patients do functional exercise early such as ambulation to recovery the hip function. It also had less total postoperative complications and internal fixation failure for the poor quality of the original studies and the limited number of studies, a prudent choice is suggested and more high-quality, large-sample studies are need.
Aged ; Bone Nails ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; Fracture Fixation, Intramedullary ; Humans ; Treatment Outcome

OBJECTIVE: To investigate the relationship between the shape of the lateral wall and the early failure of internal fixation in the fracture of the femoral trochanteric region(FFT). METHODS: Total 295 patients with femoral trochanteric fracture underwent internal fixation from January 2015 to January 2020 were selected. The patients were divided into two groups according to whether there was early internal fixation failure after surgery, 19 patients in the failure group and 276 patients in the normal group. Gender, affected side, age, AO classification, body mass index(BMI), preoperative hemoglobin, X-ray measurement of lower lateral wall thickness, preoperative internal diseases, intraoperative blood loss, postoperative tip apex distance(TAD), postoperative neck shaft angle, operation time and other data were compared between two groups. The shape of the lateral wall was compared between two groups, and the correlation between the shape of the lateral wall and the early internal fixation failure of femoral trochanteric fracture was analyzed. RESULTS: All patients were followed up for more than 1 year. There was no significant difference between two groups in terms of intraoperative blood loss, operation time, postoperative TAD, and postoperative neck shaft angle(P>0.05). At the latest follow-up, the visual anaglue scale (VAS) of the failure group was higher than that of the normal group(P<0.01), and the Harris score of the failure group was lower than that of normal group(P<0.05). The receiver operator characteristic (ROC) curve between shape of lateral wall and failure of early internal fixation of femoral trochanteric fracture was drawn. The critical value of the midpoint lateral wall thickness was 16.5 mm, and the area under the ROC curve was 0.845;The critical value of average sidewall thickness was 16.5 mm, and the area under ROC curve was 0.838;The critical value of the axial area of the sidewall was 7.5 mm, and the area under the ROC curve was 0.826. CONCLUSION The shape of the lateral femoral wall measured by CT could be used as a predictive factor for the early failure of internal fixation of femoral trochanteric fractures. For patients at risk, more reasonable surgical plans and postoperative preventive measures should be developed.
Humans ; Treatment Outcome ; Fracture Fixation, Intramedullary ; Bone Nails ; Retrospective Studies ; Hip Fractures/surgery* ; Fracture Fixation, Internal

No abstract available.
Fracture Fixation, Intramedullary

The reamer crack, followed by breakage at its distal part occurred during intramedullary nailing of tibial shaft fracture. The broken reamer was trapped in the intramedullary canal, making it very difficult to pull out. We successfully extracted the broken reamer by retrograde impaction through the fracture site and completed intramedullary nailing procedure. Thus, we present this case with a review of the literature.
Fracture Fixation, Intramedullary ; Tibia*

Endcap placement after intramedullary nailing can be cumbersome. Misplacement of the endcap which may be difficult to extract may occur. In this report, a simple Kirschner wire device with 'fish-hook' technique may ease the procedure without further violating bony or soft tissues.
Fracture Fixation, Intramedullary* ; Tibia*

No abstract available.
Fracture Fixation, Intramedullary

No abstract available.
Fracture Fixation, Intramedullary

No abstract available.
Fracture Fixation, Intramedullary*

To study the development of distraction at the fracture site according to inaccurate insertion of the distal screw in treatment of femoral shaft fracture with interlocking intramedullary nail, we prepared 24 femoral bone model, fixed them with interlocking intramedullary nails after artificially making transverse fracture or spiral fracture at mid 1/3 of femoral shaft and distal 1/3 of femoral shaft. The cephalocaudal insertion angles of the distal screws ranged from 5.2 to 45.4. As the insertion angles increased, the distances between the fractured sites ranged from 0.1 to 8.2mm. Distractions splited more than 5mm were seen in the average insertion angle of 34.3+/-9.4 (28.2 -45.4 ). When the insertion was made few millimeter proximal from the center of the distal screw hole, which was parallel to the transverse section of the femur model, fracture distraction ranged from minimum 1.8mm to maximum 5.0mm. In conclusion, the cephalocaudal insertion angle or location of the distal screw can be reason for the distraction between the fractured sites in internal fixation with intramedullary nail in long bone like femur. To prevent the distraction of fractured site, it is important to make the insertion of the distal screw parallel to the transverse section of the femur and to insert into the center of the screw hole.
Femur ; Fracture Fixation, Intramedullary*