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Interlocking intramedullary nail fixation with additional bone grafting from trochanter via a femoral hollow trephine in the treatment of femoral shaft fractures: design and clinical application

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Abstract

Purpose

The purpose of this study was to describe and evaluate the clinical application of the technique of interlocking intramedullary (IM) nailing via an entry point at the tip of greater trochanter using a specially designed femoral hollow trephine to stabilize diaphyseal fractures of the femur.

Methods

From February 2010 to April 2014, 35 consecutive patients with femoral shaft fractures were treated by the therapy of bone grafting from trochanter region with interlocking IM nail. The average age of these 23 male and 12 female patients was 37.5 years (range, 22–67 years). Fractures were classified according to AO classification system (15 type A, 17 type B, 3 type C). Femoral canal reaming and the collection of cancellous bone were simultaneously performed in a single step with the specially designed femoral hollow trephine, followed by regular IM nailing procedure.

Results

Of the 35 cases, the mean volume of spongy bone obtained was 5.63 cm3 (range, 3.0-7.0 cm3). Thirty-five patients with femoral shaft fractures had a mean follow-up period of 16.2 months (range, 12-22 months). All patients achieved bony union, at a mean of 5.4 months (range, 4-6 months). No patient developed a delayed union or a nonunion. There were no complications such as infections, injury of vascular and nerve, or heterotopic ossification in hip.

Conclusions

These results indicate that the technique of use of IM nailing with the femoral hollow trephine significantly decreases the occurrence of nonunion in femoral shaft fractures.

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Acknowledgments

This work was supported by National TCM Traumotology and Orthopedics Key Discipline (100508), Shanghai TCM leading talent construction project (2012-63-15), Shanghai leading talent project (041), The Shanghai TCM genre the Shi’s SHANGKE heritage base project (ZYSNXD-CC-HPGC-JD-001, ZY3-CCCX-1-1003), Shanghai Health Bureau in pharmaceutical research special (2014LP096A) and Shanghai 3-year action project of further accelerating TCM development (ZY3-CCCX-3-3004).

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Authors and Affiliations

  1. Department of Orthopaedic and Traumatology, Shuguang Hospital affiliated to Shanghai TCM University, No. 528 Zhangheng Road, Shanghai, 201203, China

    Yinwen Liu, Yuxin Zheng, Ziliang Shen, Shuqiang Wang, Xiaoen Wei, Xinfeng Gu, Hongsheng Zhan & Yong Kuang

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  1. Yinwen Liu
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  2. Yuxin Zheng
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  3. Ziliang Shen
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  4. Shuqiang Wang
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  5. Xiaoen Wei
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  6. Xinfeng Gu
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  7. Hongsheng Zhan
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  8. Yong Kuang
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Correspondence to Hongsheng Zhan.

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Liu, Y., Zheng, Y., Shen, Z. et al. Interlocking intramedullary nail fixation with additional bone grafting from trochanter via a femoral hollow trephine in the treatment of femoral shaft fractures: design and clinical application. International Orthopaedics (SICOT) 41, 397–402 (2017). https://doi.org/10.1007/s00264-016-3207-2

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  • DOI: https://doi.org/10.1007/s00264-016-3207-2

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