TY - JOUR
T1 - A forward-striking technique for reducing fracture gaps during intramedullary nailing
T2 - A technical note with clinical results
AU - Lim, Seung Jae
AU - So, Sang Yeon
AU - Yoon, Yong Cheol
AU - Cho, Won Tae
AU - Oh, Jong Keon
N1 - Publisher Copyright:
© 2015 Elsevier Ltd.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Introduction A residual postoperative fracture gap between major bone fragments following intramedullary nailing of long-bone fractures is recognised as one of the major risk factors for delayed union and non-union. The most common method for reducing a fracture gap after nail insertion is through application of the backstroke technique. We introduce forward-striking as a new and simple technique that can be used to reduce fracture gaps during cephalomedullary or intramedullary nailing. Patients and methods The forward-striking technique was used in 20 patients with subtrochanteric or femoral shaft fractures and three patients with tibial shaft fractures who underwent cephalomedullary or intramedullary nailing at two university teaching hospitals between February 2013 and March 2014. Results Bone union was achieved in all cases, with a mean time of 5.7 months (range, 3-9 months). No major complications, including, non-union, implant failure, or infection, were encountered during the follow-up period. Conclusion A forward-striking technique is simple, convenient, and highly efficient in terms of reducing fracture gaps during cephalomedullary or intramedullary nailing. The advantage of this technique is that it carries no risk of deforming the proximal interlocking screw, prevents excessive protrusion of the nail, and enables the lag screw to be placed into the optimal lag screw position relative to the femoral head at the time of cephalomedullary nailing. The forward-striking technique is particularly useful if no compression screw system is available.
AB - Introduction A residual postoperative fracture gap between major bone fragments following intramedullary nailing of long-bone fractures is recognised as one of the major risk factors for delayed union and non-union. The most common method for reducing a fracture gap after nail insertion is through application of the backstroke technique. We introduce forward-striking as a new and simple technique that can be used to reduce fracture gaps during cephalomedullary or intramedullary nailing. Patients and methods The forward-striking technique was used in 20 patients with subtrochanteric or femoral shaft fractures and three patients with tibial shaft fractures who underwent cephalomedullary or intramedullary nailing at two university teaching hospitals between February 2013 and March 2014. Results Bone union was achieved in all cases, with a mean time of 5.7 months (range, 3-9 months). No major complications, including, non-union, implant failure, or infection, were encountered during the follow-up period. Conclusion A forward-striking technique is simple, convenient, and highly efficient in terms of reducing fracture gaps during cephalomedullary or intramedullary nailing. The advantage of this technique is that it carries no risk of deforming the proximal interlocking screw, prevents excessive protrusion of the nail, and enables the lag screw to be placed into the optimal lag screw position relative to the femoral head at the time of cephalomedullary nailing. The forward-striking technique is particularly useful if no compression screw system is available.
KW - Cephalomedullary nailing
KW - Forward-striking technique
KW - Fracture gap
KW - Intramedullary nailing
UR - http://www.scopus.com/inward/record.url?scp=84951574195&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2015.08.024
DO - 10.1016/j.injury.2015.08.024
M3 - Article
C2 - 26358514
AN - SCOPUS:84951574195
SN - 0020-1383
VL - 46
SP - 2507
EP - 2511
JO - Injury
JF - Injury
IS - 12
ER -