| Abstract [eng] |
Objective To evaluate the rate of and reasons for reosteosynthesis after osteosynthesis of the middle third of the femoral diaphysis. Materials and methods Retrospectively, 237 medical histories of patients with diaphyseal femur fractures, who underwent primary femoral osteosynthesis in the Centre of Traumatology and Orthopaedics of the Vilnius University Emergency Hospital in 2003–2010 were analyzed; 229 osteosyntheses were enrolled into the final study. All patients, by the osteosynthesis method, were grouped into three groups: osteosynthesis with Dynamic Compression Plate (DCP), intramedullary nailing (IMN), and AO external fixation apparatus (EF). These groups were investigated for the reasons of reosteosynthesis (pseudarthrosis, mechanical complications, suppuration). Results A fracture type (by AO classification) was diagnosed to 133 (56.1%), B type – 67 (28.3%), and C type to 37 patients (15.6%). In first group (DCP) there were 150 cases of osteosynthesis, from which 29 (19.3%) were reoperated on because of mechanical complications, 17 (11.3%) because of pseudarthrosis, and 4 (2.6%) because of suppuration. In the second group, there were 52 IM nailing cases, from which none were reoperated because of mechanical complications, altthough 3 (5.8%) had to be reoperated because of pseudarthrosis and one (1.9%) because of suppuration. In the third group, there were 27 external fixations of which 7 (26%), 10 (27%) and 10 (27%) were reoperated on because of mechanical complications, pseudarthrosis and suppuration, respectively. Conclusions Osteosynthesis with intramedullary nail is a superior method to internal fixation with DCP, because the rate of reosteosynthesis after intramedullary nailing was lower. We recommend, when possible, to perform osteosynthesis with intramedullary nail for the treatment of diaphyseal femur fractures. |
