Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails
Abstract Introduction The role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture trea...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-08-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Online Access: | https://doi.org/10.1186/s13018-021-02633-w |
| _version_ | 1817995280164847616 |
|---|---|
| author | Tzu-Hao Wang Hao-Chun Chuang Fa-Chuan Kuan Chih-Kai Hong Ming-Long Yeh Wei-Ren Su Kai-Lan Hsu |
| author_facet | Tzu-Hao Wang Hao-Chun Chuang Fa-Chuan Kuan Chih-Kai Hong Ming-Long Yeh Wei-Ren Su Kai-Lan Hsu |
| author_sort | Tzu-Hao Wang |
| collection | DOAJ |
| description | Abstract Introduction The role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesized that open cerclage wiring can be applied in patients with severe comminuted femoral shaft fractures without affecting bone healing. Patients and methods This retrospective cohort study used data from consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into the wire and no wire groups according to the surgical technique used, and their union rate was recorded. The patients were then divided into the union and nonunion groups, and their perioperative data were analyzed. Results In total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini-open techniques without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures achieved union smoothly, and no significant difference was observed in any perioperative data between the union and nonunion groups. Discussion Augmentation with open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or greatly displaced. Thus, open cerclage wiring can be used for fracture treatment without decreasing the union rate. |
| first_indexed | 2024-04-14T02:03:41Z |
| format | Article |
| id | doaj.art-84976639d4c84015833396a2213c0213 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T02:03:41Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-84976639d4c84015833396a2213c02132022-12-22T02:18:45ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-08-011611810.1186/s13018-021-02633-wRole of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nailsTzu-Hao Wang0Hao-Chun Chuang1Fa-Chuan Kuan2Chih-Kai Hong3Ming-Long Yeh4Wei-Ren Su5Kai-Lan Hsu6Department of Orthopaedics, Kaohsiung Municipal Min-Sheng HospitalDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Biomedical Engineering, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityAbstract Introduction The role of open cerclage wiring in comminuted femoral shaft fracture treatment with intramedullary nails remains unclear. Here, we analyzed the effect of open cerclage wiring and the risk factors for nonunion after interlocking nailing in comminuted femoral shaft fracture treatment. We hypothesized that open cerclage wiring can be applied in patients with severe comminuted femoral shaft fractures without affecting bone healing. Patients and methods This retrospective cohort study used data from consecutive patients who underwent interlocking nail fixation of a comminuted femoral shaft fracture between January 1, 2009, and December 31, 2016. First, eligible patients were divided into the wire and no wire groups according to the surgical technique used, and their union rate was recorded. The patients were then divided into the union and nonunion groups, and their perioperative data were analyzed. Results In total, 71 comminuted femoral shaft fractures treated with interlocking nail fixation were included: 38 fractures (53.5%) augmented with the open wiring technique and 33 reduced with closed or mini-open techniques without wiring. The wire group demonstrated significant improvements in fracture reduction compared with the no wire group, whereas no significant difference was observed in the union rate between the wire and no wire groups (p = 0.180). Moreover, 46 (65%) of 71 fractures achieved union smoothly, and no significant difference was observed in any perioperative data between the union and nonunion groups. Discussion Augmentation with open cerclage wiring is indicated for comminuted femoral shaft fractures treated with intramedullary nails, even when the fragments are large or greatly displaced. Thus, open cerclage wiring can be used for fracture treatment without decreasing the union rate.https://doi.org/10.1186/s13018-021-02633-w |
| spellingShingle | Tzu-Hao Wang Hao-Chun Chuang Fa-Chuan Kuan Chih-Kai Hong Ming-Long Yeh Wei-Ren Su Kai-Lan Hsu Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails Journal of Orthopaedic Surgery and Research |
| title | Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| title_full | Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| title_fullStr | Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| title_full_unstemmed | Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| title_short | Role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| title_sort | role of open cerclage wiring in patients with comminuted fractures of the femoral shaft treated with intramedullary nails |
| url | https://doi.org/10.1186/s13018-021-02633-w |
| work_keys_str_mv | AT tzuhaowang roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT haochunchuang roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT fachuankuan roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT chihkaihong roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT minglongyeh roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT weirensu roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails AT kailanhsu roleofopencerclagewiringinpatientswithcomminutedfracturesofthefemoralshafttreatedwithintramedullarynails |