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- Title
Retrograde intramedullary nailing with supplemental plate and lag screws allows early weight bearing following distal end-segment femur fractures (AO/OTA 33) in a low-resource setting.
- Authors
Adesina, Stephen Adesope; Amole, Isaac Olusayo; Adefokun, Imri Goodness; Adegoke, Adepeju Olatayo; Akinwumi, Akinsola Idowu; Odekhiran, Ehimen Oluwadamilare; Durodola, Adewumi Ojeniyi; Ojo, Simeon Ayorinde; Eyesan, Samuel Uwale
- Abstract
Purpose: To underline the feasibility of achieving early weight bearing in patients with distal end-segment femur fractures (AO/OTA 33) treated with retrograde intramedullary nailing and supplemental plate or lag screws in the absence of C-arm. Methods: 41 distal end-segment femur fractures (DFFs) included in the study were treated with SIGN nails with or without a side plate in a center that lacked intraoperative fluoroscopy and fracture table. A medial or lateral para-patellar incision was used for fracture reduction, nail insertion and side plate placement. Follow-ups were done at six weeks, 12 weeks, and six months post-operatively. Results: Distal end-segment fractures constituted 13.2% of all femur fractures treated. The patients' mean age and range were 49.6 and 23–83 years respectively. They were mostly injured in road traffic accidents. 27 were daily-income earners. By the 12th week post-operatively, 82.1% of them could flex their knee beyond 90°, all of them could bear weight fully, and 71.8% could squat & smile. Conclusion: The study highlighted the procedure for retrograde nailing of DFFs in a setting without the requisite facilities for minimally-invasive surgeries. The findings demonstrated the feasibility of achieving an expedited weight bearing for the predominantly daily-income-earning victims to ensure early return to work and poverty reduction. While the small sample size is a limitation, the study does provide information that could serve as a basis for future randomized controlled trials in low-resource settings.
- Subjects
NIGERIA; WEIGHT-bearing (Orthopedics); MIDDLE-income countries; FEMORAL fractures; TRAFFIC accidents; FRACTURE fixation; ORTHOPEDIC implants; BONE screws; DESCRIPTIVE statistics; SURGICAL therapeutics; LONGITUDINAL method; WALKING; RESOURCE-limited settings; BODY movement; FLUOROSCOPY; LOW-income countries
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2024, Vol 34, Issue 3, p1519
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-023-03828-z