ABSTRACT
OBJECTIVE: To report our experience with a novel alternative method of freehand interlocking of intramedullary nails. This method requires the use of only anterior-posterior image intensification and an intramedullary guide wire to verify screw placement. Our results are compared with historical results in the literature. METHODS: A total of 815 patients were treated using this technique from January 2008 to December 2012; 603 patients had fractures of the tibia and 212 had fractures of the femur. RESULTS: The mean duration of surgery for tibial shaft fractures was 55.6 minutes (range 42-60 minutes) and that for fractures of the femur was 78 minutes (range 50-90 minutes). The mean time for each distal locking was 3.8 minutes (2.5-5.1 minutes), with 7.65 seconds of exposure to radiation during each block. CONCLUSIONS: The surgical technique is simple, easy and reproducible. Mean time of surgery and radiation exposure was less than that in the literature. A comparative study should be performed.
Subject(s)
Bone Screws , Femoral Fractures/surgery , Fracture Fixation, Intramedullary , Tibial Fractures/surgery , Tomography, X-Ray Computed , Equipment Contamination/prevention & control , Femoral Fractures/diagnostic imaging , Fracture Fixation, Intramedullary/methods , Humans , Operative Time , Prospective Studies , Radiation Dosage , Radiation Protection , Tibial Fractures/diagnostic imagingABSTRACT
Os autores fizeram uma análise das melhores evidências clínicas da literatura sobre os métodos de osteossíntese para as fraturas expostas diafisárias da tíbia. Métodos: Descrevem a metanálise publicada por Bhandari et al em 2001, que compara de forma randomizada os diversos métodos de osteossíntese utilizados neste tipo de fratura e discutem seus resultados. Conclusões: Concluem que, atualmente, há evidências convincentes de que o uso das hastes intramedulares não fresadas diminui a incidência de reoperações, de infecção superficial e de consolidação viciosa das fraturas, quando comparadas com o fixador externo, sendo, dessa forma, a melhor opção para o tratamento das fraturas expostas diafisárias da tíbia. A vantagem do uso da haste intramedular fresada sobre a não fresada permanece incerto
