Change of intramedullary pressure and fat intravasation during intramedully nailing of fresh femoral fractures / 中国矫形外科杂志

ABSTRACT

Objective To study the factors leading to intramedullary pressure (IMP) change during openintramedullynailing (OIMN) of fresh femoral fractures and the relation between fat intravasation and IMP. MethodFifty patients with femoral fractures were submitted to OIMN in early stage after injury. Before operation, a hollow probe was screwed into the medullary cavity and linked with a monitor to record the dynamic pressure change during the OIMN process. The patients were divided into 2 groups according to their IMP. 5ml blood was taken from femoral vein of the affected limb individually before operation and just after fixation of the intramedullary nail. The blood clots were made into frozen sections and stained by oil red-O to find the free fat.The positive rate of free fat in pathological detection between patients with increased IMP and those without were compared.Result(1) Increased IMP could be recorded in some patients with "piston effect" resulted from a certain condition during OIMN. (2) For patients with increased IMP, the positive rate of free fat through pathological detection during the operation was significantly higher than that of before (p(o. ol),but that of patients without increased IMP did not change significantly. The positive rates of the two groups did not have significant difference than those of before operation. During operation, the positive rate of patients with increased IMP was significant higher than that of patients without pressure imcreasing(P