Fixator-assisted nailing of tibial fractures: New surgical technique and presentation of first 30 cases.

Autor: Semenistyy AA; City Clinical Hospital №13, 1/1 Velozavodskaya str., Moscow, 115088, Russia; F.I. Inozemtsev City Clinical Hospital, 1 Fortunatovskay str., Moscow, 105187, Russia; Russian Medical Academy of Continuous Professional Education, 2 Barrikadnaya str, Moscow, 123242, Russia. Electronic address: an.semenistyy@gmail.com., Litvina Ea EA; F.I. Inozemtsev City Clinical Hospital, 1 Fortunatovskay str., Moscow, 105187, Russia; Russian Medical Academy of Continuous Professional Education, 2 Barrikadnaya str, Moscow, 123242, Russia. Electronic address: alenalitv@mail.ru., Fedotova AG; City Clinical Hospital №13, 1/1 Velozavodskaya str., Moscow, 115088, Russia. Electronic address: annafedotova13gkb@mail.ru., Gwam C; Department of Orthopedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC, United States; Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 27157, United States., Mironov AN; F.I. Inozemtsev City Clinical Hospital, 1 Fortunatovskay str., Moscow, 105187, Russia. Electronic address: dr.mironov.andrey@gmail.com.
Jazyk: angličtina
Zdroj: Injury [Injury] 2019 Feb; Vol. 50 (2), pp. 515-520. Date of Electronic Publication: 2018 Nov 10.
DOI: 10.1016/j.injury.2018.11.015
Abstrakt: Background: Intramedullary nailing is considered a "gold standard" for treatment of tibial shaft fractures. However, some types of fractures are typically considered as "difficult for nailing". This group includes the periarticular fractures, fractures of both bones at the same level, comminuted and segmental fractures of the tibia. Fixator-assisted nailing (FAN) is an effective method treatment of these types of fractures. The main requirements for the ideal reduction device are an ease of its installation and an ability of multiplanar fracture reduction. Fixator-assisted nailing (FAN) with the use of two perpendicular to each other monolateral tubular frames perfectly meets these requirements. In this study we present this new surgical technique and the analysis of first 30 cases.
Methods: A prospective analysis was conducted for 30 patients with "difficult for nailing" tibial fractures treated with fixator-assisted nailing in our institution between September 1 st , 2017, and March 1 st , 2018. The duration of surgery and its different stages, the time of fluoroscopy, difficulties encountered during surgery, were analyzed. Clinical and radiological methods were used to evaluated reduction quality.
Results: In all 30 cases the acceptable reduction was achieved. The mean duration of the surgical procedure was 73.7 ± 3 min. The mean duration of fluoroscopy 85.9 ± 4.8 s. In 7 cases we faced with technical difficulties, which were successfully addressed.
Conclusion: The described technique of FAN is an effective method for the treatment of "difficult for nailing" tibial fractures. Future multi-centered studies with a larger number of patients are needed to validate our results.
(Copyright © 2018. Published by Elsevier Ltd.)
Databáze: MEDLINE
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