Manipulation with Schanz screws for closed reduction of femoral shaft fractures during intramedullary nailing

To use Schanz screws as a simple and effective method for closed reduction of femoral shaft fractures. In the present cohort study, which was carried out in Shohada Orthopedic Center, Tabriz, Iran between January 2004 and February 2005, 30 adult patients, with a mean age of 29 [18-65 years] with femoral shaft fractures underwent closed reduction with Schanz pins. The patients were followed up for 12 months. Reduction was satisfactory in 93.3% of patients. The average time for reduction was significantly shorter if treated in the first 48 hours, and if the amount of pre-operative traction approached 15% of the body weight. Reduction time was also shorter in Winquist-Hansen type III and IV fractures than in type I and II fractures [5.9 +/- 0.2 minutes versus 15.7 +/- 0.4 minutes]. There was 13% valgus deformity [5-10 degrees], 33% external mal-rotation [5-15 degrees] and 37% shortening [up to 1-3 cm]. We encountered no need for blood transfusion or bone grafting. Schanz screws provide a very effective method for closed reduction of femoral shaft fractures, and complications are similar to or less than other methods, especially if carried out in the first 48 hours after the trauma and if the weight for pre-operative traction approaches 15% of body weight

Comparison between ender and unreamed interlocking nails in tibial shaft fractures

To compare ender nails and unreamed interlocking nails in a randomized clinical trial study. From March 2001 to March 2003, 131 patients with tibial fractures of the central two thirds of the tibia were admitted to the emergency ward of Shohada Hospital, Tabriz, Iran and were randomized to either an ender tibial nail or an undreamed interlocking tibial nail as their primary treatment. Age, gender, types of fracture, and surgical outcomes were recorded at the time of surgery, during hospital stay, and during the course of 9 months follow-up. Sixty-seven patients underwent surgery with interlocking nails and 64 with ender nails. No statistically significant difference was found between the 2 groups concerning mal-union, delayed union, and device failure. Durations of hospital stay, and time needed to achieve union was significantly higher in the unreamed interlocking group. Non-union and infection rate were higher in the ender group [p<0.05]. The results of our study support those of other studies that indicate the choice between the 2 methods of unreamed nailing is mainly controversial, depending on the priorities of the patient and surgeon