Management of complex femoral nonunion with monorail external fixator: A prospective study
| Autor: | Hemendra Kumar Agrawal, Vinod Sharma, Ashish Jaiman, Balvinder Singh, Vipin Khatkar, Shailender Khare, Mohit Garg, Sumit Batra |
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| Rok vydání: | 2016 |
| Předmět: |
030222 orthopedics
medicine.medical_specialty External fixator business.industry medicine.medical_treatment Radiography Nonunion Bone healing medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Monorail Medicine Distraction osteogenesis Original Article Orthopedics and Sports Medicine Femur 030212 general & internal medicine business Prospective cohort study |
| Zdroj: | Journal of Clinical Orthopaedics and Trauma. 7:191-200 |
| ISSN: | 0976-5662 |
| Popis: | Aim To evaluate 30 patients who underwent distraction osteogenesis with monorail external fixator for complex femoral nonunion. Method Complex femoral nonunion includes infective non-union, gap nonunion, and limb-length discrepancy secondary to traumatic bone loss, which needs specialized treatment to ensure the functional integrity of femoral bone. 30 patients, including 28 male and 2 female (aged 22–62 years) patients, underwent surgical debridement followed by bone transport with monorail fixator. The lengthening index, radiographic consolidation index, functional status, bone healing, and various problems, obstacles, and complications encountered during the treatment were assessed. Results Patients underwent a mean of 2.2 (range 1–4) surgeries before presentation. The mean bone defect after surgical debridement was 5.83 cm (range 2–16 cm). The mean treatment duration was 204.7 days (range 113–543 days). The mean lengthening index was 13.06 days/cm with range from 12 to 16 days/cm. Mean maturation index was 23.51 days/cm with range from 17 to 45.5 days/cm. In our study, bone result was excellent in 17, good in 9, fair in 3, and poor in 1 patient. In our study functional outcome is excellent in 9 [30%], good in 14 [46.67%], fair in 5, and poor in 2 patients. In our study, we encountered 34 problems, 17 obstacles, and 8 complications. Conclusion We concluded that monorail external fixator is an effective treatment option for complex nonunion femoral shaft fracture and its functional outcome is comparable with any other treatment options. Lack of complications and its effectiveness makes monorail external fixator the treatment of choice for complex nonunion femoral shaft. |
| Databáze: | OpenAIRE |
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