A forward-striking technique for reducing fracture gaps during intramedullary nailing

A technical note with clinical results

Seung Jae Lim, Sang Yeon So, Yong Cheol Yoon, Won Tae Cho, Jong-Keon Oh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction A residual postoperative fracture gap between major bone fragments following intramedullary nailing of long-bone fractures is recognised as one of the major risk factors for delayed union and non-union. The most common method for reducing a fracture gap after nail insertion is through application of the backstroke technique. We introduce forward-striking as a new and simple technique that can be used to reduce fracture gaps during cephalomedullary or intramedullary nailing. Patients and methods The forward-striking technique was used in 20 patients with subtrochanteric or femoral shaft fractures and three patients with tibial shaft fractures who underwent cephalomedullary or intramedullary nailing at two university teaching hospitals between February 2013 and March 2014. Results Bone union was achieved in all cases, with a mean time of 5.7 months (range, 3-9 months). No major complications, including, non-union, implant failure, or infection, were encountered during the follow-up period. Conclusion A forward-striking technique is simple, convenient, and highly efficient in terms of reducing fracture gaps during cephalomedullary or intramedullary nailing. The advantage of this technique is that it carries no risk of deforming the proximal interlocking screw, prevents excessive protrusion of the nail, and enables the lag screw to be placed into the optimal lag screw position relative to the femoral head at the time of cephalomedullary nailing. The forward-striking technique is particularly useful if no compression screw system is available.

Original languageEnglish
Pages (from-to)2503-2507
Number of pages5
JournalInjury
Volume46
Issue number12
DOIs
Publication statusPublished - 2015 Dec 1

Fingerprint

Intramedullary Fracture Fixation
Nails
Bone and Bones
Tibial Fractures
Femoral Fractures
Bone Fractures
Thigh
Teaching Hospitals
Infection

Keywords

  • Cephalomedullary nailing
  • Forward-striking technique
  • Fracture gap
  • Intramedullary nailing

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Cite this

A forward-striking technique for reducing fracture gaps during intramedullary nailing : A technical note with clinical results. / Lim, Seung Jae; So, Sang Yeon; Yoon, Yong Cheol; Cho, Won Tae; Oh, Jong-Keon.

In: Injury, Vol. 46, No. 12, 01.12.2015, p. 2503-2507.

Research output: Contribution to journalArticle

Lim, Seung Jae ; So, Sang Yeon ; Yoon, Yong Cheol ; Cho, Won Tae ; Oh, Jong-Keon. / A forward-striking technique for reducing fracture gaps during intramedullary nailing : A technical note with clinical results. In: Injury. 2015 ; Vol. 46, No. 12. pp. 2503-2507.
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N2 - Introduction A residual postoperative fracture gap between major bone fragments following intramedullary nailing of long-bone fractures is recognised as one of the major risk factors for delayed union and non-union. The most common method for reducing a fracture gap after nail insertion is through application of the backstroke technique. We introduce forward-striking as a new and simple technique that can be used to reduce fracture gaps during cephalomedullary or intramedullary nailing. Patients and methods The forward-striking technique was used in 20 patients with subtrochanteric or femoral shaft fractures and three patients with tibial shaft fractures who underwent cephalomedullary or intramedullary nailing at two university teaching hospitals between February 2013 and March 2014. Results Bone union was achieved in all cases, with a mean time of 5.7 months (range, 3-9 months). No major complications, including, non-union, implant failure, or infection, were encountered during the follow-up period. Conclusion A forward-striking technique is simple, convenient, and highly efficient in terms of reducing fracture gaps during cephalomedullary or intramedullary nailing. The advantage of this technique is that it carries no risk of deforming the proximal interlocking screw, prevents excessive protrusion of the nail, and enables the lag screw to be placed into the optimal lag screw position relative to the femoral head at the time of cephalomedullary nailing. The forward-striking technique is particularly useful if no compression screw system is available.

AB - Introduction A residual postoperative fracture gap between major bone fragments following intramedullary nailing of long-bone fractures is recognised as one of the major risk factors for delayed union and non-union. The most common method for reducing a fracture gap after nail insertion is through application of the backstroke technique. We introduce forward-striking as a new and simple technique that can be used to reduce fracture gaps during cephalomedullary or intramedullary nailing. Patients and methods The forward-striking technique was used in 20 patients with subtrochanteric or femoral shaft fractures and three patients with tibial shaft fractures who underwent cephalomedullary or intramedullary nailing at two university teaching hospitals between February 2013 and March 2014. Results Bone union was achieved in all cases, with a mean time of 5.7 months (range, 3-9 months). No major complications, including, non-union, implant failure, or infection, were encountered during the follow-up period. Conclusion A forward-striking technique is simple, convenient, and highly efficient in terms of reducing fracture gaps during cephalomedullary or intramedullary nailing. The advantage of this technique is that it carries no risk of deforming the proximal interlocking screw, prevents excessive protrusion of the nail, and enables the lag screw to be placed into the optimal lag screw position relative to the femoral head at the time of cephalomedullary nailing. The forward-striking technique is particularly useful if no compression screw system is available.

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