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Song W, Wang Y, Chen W, Zhang Z, Liu X, Ou G, Cheng B, Lin H. The comparison of the Effect of double reverse traction repositor (DRTR) and traction table assisted Anterograde Intramedullary nail in treatment of femoral shaft fractures. BMC Musculoskelet Disord 2023; 24:303. [PMID: 37072713 PMCID: PMC10111643 DOI: 10.1186/s12891-023-06421-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023] Open
Abstract
OBJECTIVE The objective of this study was to compare the clinical efficacy of DRTR (Double Reverse Traction Repositor, DRTR)and traction table in the treatment of femoral shaft fractures with the aid of AN-IMN (Antegrade intramedullary nailing). PATIENTS AND METHODS In this study, patients with femoral shaft fractures admitted to the Department of Orthopedics at Zhaoqing First People's Hospital from May 2018 to October 2022 were recruited. All patients were treated with anterograde intramedullary nailing, with 23 patients in the DRTR-assisted group and 21 patients in the traction table-assisted group. The demographic characteristics, fracture classification, intraoperative data, postoperative data, and prognostic indicators of the two groups were recorded and analyzed retrospectively. All procedures were performed by the same team of experienced physicians. RESULTS All the patients in the two groups were followed up for more than 12 months. Both traction methods could provide stable traction for the operator during AN-IMN, and there was no significant difference in demographic characteristics and fracture classification. The intraoperative fluoroscopy times and opening reduction rate of the DRTR group were lower than those of the traction table group (P < 0.05), and the postoperative Harris Hip Score, as well as the Lyshol Lysholm knee function Score of the DRTR group, were significantly higher than the traction table group members (P < 0.05). Postoperative complications such as perineal soft tissue injury and lateral femoral cutaneous nerve injury occurred in the traction table group, but not in the DRTR group. CONCLUSION DRTR can safely and effectively provide continuous and stable traction in the femoral shaft fractures surgery, and outperforms the traction table in the number of intraoperative fluoroscopy, opening reduction rate, reduction of complications, and postoperative joint function score.
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Affiliation(s)
- Wei Song
- Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China.
| | - Yueying Wang
- Clinical Laboratory of the First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Weihao Chen
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China
| | - Zhenqian Zhang
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China
| | - Xuzhou Liu
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China
| | - Guoji Ou
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China
| | - Benqiang Cheng
- Department of Orthopaedics, The First people's Hospital of Zhaoqing, Zhaoqing, China
| | - Hongsheng Lin
- Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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He YK, Wang YC, Li FF. Is the traction table necessary to treat femoral fractures with intramedullary nailing? A meta-analysis. J Orthop Surg Res 2023; 18:277. [PMID: 37020232 PMCID: PMC10074654 DOI: 10.1186/s13018-023-03659-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The traction table is generally used in femoral intramedullary nailing surgery. Recently, some published studies have shown that the same or better treatment effects can be gotten without a traction table. It remains no consensus on this issue. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was applied in this study. We searched PubMed, Embase, Web of Science, and Cochrane Library databases for eligible studies. The random-effect model was used to calculate the standardized mean difference (SMD) and risk ratios with 95% CIs. Trial sequential analysis (TSA) was performed to verify the results. RESULTS The pooled estimates of seven studies, including 266 cases each in the manual traction group and traction table group, indicated that manual traction could shorten operative time [SMD, - 0.77; 95% CI (- 0.98, - 0.55); P < 0.00001] and preoperative set-up time [SMD, - 2.37; 95% CI (- 3.90, - 0.84); P = 0.002], but it would not reduce intraoperative blood loss volume and fluoroscopy time. No statistical difference was found in their fracture healing time, postoperative Harris scores, and malunion rate. The use of a Traction repositor could reduce the set-up time [SMD, - 2.48; 95% CI (- 4.91, - 0.05); P < 0.00001]. CONCLUSIONS Compared with manual traction, the traction table in femoral intramedullary nailing surgery lengthened operative time and preoperative set-up time. At the same time, it did not show significant advantages in reducing blood loss volume and fluoroscopy time, or improving prognosis. In clinical practice, the optimal surgical plan must be made on a case-by-case basis to avoid unnecessary traction table use.
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Affiliation(s)
- Yu-Kun He
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, Guangdong, China
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Yi-Chong Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510000, Guangdong, China
| | - Feng-Feng Li
- Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 210008, Nanjing, China.
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Li DY, Liu CG, Zhang K. Whether Assisted Intramedullary Nail Implantation Without Traction Table is as Safe and Effective as Using Traction Table of Older Intertrochanteric Fracture Patients? Clin Interv Aging 2023; 18:387-395. [PMID: 36926471 PMCID: PMC10013570 DOI: 10.2147/cia.s399608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/04/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose Despite promising clinical outcome proposals, there has been relatively little published regarding the use of traction table-assisted intramedullary nail implantation for intertrochanteric fractures. The purpose of this study is to further summarize and evaluate published clinical studies comparing the clinical outcomes of using traction table and without traction table in the management of intertrochanteric fracture. Methods A comprehensive literature search using PubMed, Cochrane Library, and Embase was systematically performed to evaluate all studies included in the literature up to May 2022. The search terms included "intertrochanteric fractures", "hip fractures", and "traction table" with Boolean operators "AND" and "OR". The following information was extracted and summarized: demographic information, setup time, surgical time, amount of bleeding, fluoroscopy exposure time, reduction quality, and Harris Hip Score (HHS). Results A total of eight clinical controlled studies involving 620 patients were eligible for the review. The mean age at the time of injury was 75.3 years (traction table group 75.7 years, non-traction table group 74.9 years). The most common assisted intramedullary nail implantation method of non-traction table group included lateral decubitus position (4 studies), traction repositor, (3 studies) and manual traction (1 studies). Included studies results all support that there was no difference between the two groups in terms of reduction quality and Harris Hip Score, and the non-traction table group had an advantage in terms of setup time. However, there were still disputes in terms of surgical time, amount of bleeding and fluoroscopy exposure time. Conclusion For patients with intertrochanteric fractures, assisting intramedullary nail implantation without traction table is as safe and effective as using traction table and doing so without a traction table may be more advantageous in terms of setup time.
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Affiliation(s)
- Dong-Yang Li
- Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.,Xi'an Medical University, Xi'an, People's Republic of China
| | - Chun-Gui Liu
- Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.,Xi'an Medical University, Xi'an, People's Republic of China
| | - Kun Zhang
- Department of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China
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A new surgical strategy for the treatment of tibial pilon fractures with MIPO facilitated by double reverse traction repositor. Sci Rep 2022; 12:7074. [PMID: 35490177 PMCID: PMC9056500 DOI: 10.1038/s41598-022-11150-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/18/2022] [Indexed: 11/08/2022] Open
Abstract
The present study aims to introduce a technique combining double reverse traction repositor (DRTR) with minimally invasive plate osteosynthesis (MIPO) in the surgical treatment of pilon fractures and to observe the efficiency of this approach during a short-term follow-up period. From January to December 2018, patients with pilon fractures who were treated by MIPO with DRTR were reviewed. The demographic and fracture characteristics, surgical data, and prognostic data of 24 patients were extracted. In all 24 patients, closed reduction was achieved with the MIPO technique, and excellent functional and radiological outcomes were observed. The average duration of surgery and intraoperative blood loss were 95.0 ± 14.2 min and 152.1 ± 52.1 ml, respectively. A mean of 16.0 ± 1.9 intraoperative fluoroscopies were conducted. At the 12-month follow-up evaluation, the average AOFAS score was 85.2 ± 5.1. Anatomic or good reduction was observed in 23 (95.8%) patients. The mean ranges of motion of dorsiflexion and plantarflexion were 11.0 ± 2.7 and 32.7 ± 11.1, respectively. Two patients with deep venous thrombosis and one patient with wound non-purulent exudate were noted. Additionally, the wounds healed after routine dressing change. No other complications, including skin necrosis or delayed, non-union or malunion, were observed. The new strategy combining DRTR with MIPO in the treatment of pilon fractures allowed excellent radiological and clinical outcomes and a low postoperative complication rate to be achieved in a short-term follow-up period. Further large sample and comparative studies should be conducted to validate our results.
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Zhao K, Zhang J, Wang Z, Wang Y, Li J, Hou Z, Zhang Y, Chen W, Zhang Q. Multiplanar fracture reducer versus manual traction in the treatment of tibial shaft fractures with intramedullary nails. INTERNATIONAL ORTHOPAEDICS 2021; 46:911-917. [PMID: 34591157 DOI: 10.1007/s00264-021-05229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECT The purpose of this study was to propose a new traction device, a multiplanar fracture reducer (MFR), for the treatment of tibial shaft fractures with intramedullary nails (IMN). The efficiencies of the multiplanar fracture reducer and manual traction (MT) in the treatment of tibial shaft fractures with IMN were compared. METHODS From January 2019 to January 2020, a total of 79 patients were enrolled in this study, among whom 38 were treated with MFR while 41 were treated with MT. Their demographics and fracture characteristics, surgical data, and prognostic data between the two groups were compared. RESULTS The mean number of intra-operative fluoroscopies in the MFR group was less than that in the MT group (19.4 vs 21.2, p < 0.001); surgical procedures involving open reduction were more in the MT group than in MFR group (0 vs 5, p = 0.026); there were less assistants in the MFR group than in the MT group (1 vs 1.9, p < 0.001), while the average Lysholm Knee Function Score and knee flexion were 92.7 ± 2.0 and 128.8 ± 1.4 in the MFR group, and 91.9 ± 2.1 and 127.5 ± 1.8 in the MT group, respectively. Both LKFS and knee flexion in the MFR group were significantly better than those in the MT group (p = 0.032 and p < 0.001). The remaining data between the two groups were comparable. CONCLUSION MFR is a safe and effective device for the minimal invasive treatment of tibial shaft fractures fixed with IMN.
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Affiliation(s)
- Kuo Zhao
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Junzhe Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhongzheng Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Yuchuan Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Junyong Li
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Wei Chen
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China. .,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China. .,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.
| | - Qi Zhang
- NHC Key Laboratory of Intelligent Orthopaedic Equipment (The Third Hospital of Hebei Medical University), Shijiazhuang, 050051, Hebei, People's Republic of China.
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Li J, Zhang J, Zhao K, Zhu Y, Meng H, Jin Z, Ye D, Chen W, Zhang Y. Incidence and risk factors for decreased range of motion of the knee joint after surgery for closed tibial plateau fracture in adults. J Orthop Surg Res 2021; 16:549. [PMID: 34488833 PMCID: PMC8422622 DOI: 10.1186/s13018-021-02700-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose The aim of this study was to quantify the incidence of and identify independent risk factors for decreased range of motion (ROM) of the knee joint after surgery for closed tibial plateau fractures in adults. Methods This retrospective study was performed at the trauma centre in our hospital from January 2018 to December 2019. Data from adult patients with tibial plateau fractures treated by surgery were extracted from the electronic medical records. A total of 220 tibial plateau fracture patients were enrolled. We extracted the patients’ demographic characteristics, fracture characteristics, and surgery-related variables. Univariate and multivariate logistic regression models were used to investigate the potential independent risk factors. Results Fifty-seven patients developed decreased ROM of the knee joint at the 1-year follow-up in this study. The overall incidence was 25.9%. The independent predictors of decreased ROM after surgery, as identified in the multivariate analysis, were orthopedic polytrauma (odds ratio = 3.23; 95% CI = 1.68–6.20; p = 0.000), fracture type (Schatzker V-VI) (odds ratio = 2.52; 95% CI = 1.16–5.47; p = 0.019), and an open reduction and internal fixation approach (odds ratio = 2.10; 95% CI = 1.07–4.12; p = 0.031). Conclusions The study confirmed that patients with orthopaedic polytrauma, more complex fractures and those treated with open reduction and internal fixation (ORIF) surgery were more likely to suffer decreased ROM of the knee joint 1 year after surgery.
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Affiliation(s)
- Junyong Li
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China.,The First Hospital of Shijiazhuang City, Shijiazhuang, 050000, Hebei, P. R. China
| | - Junzhe Zhang
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Kuo Zhao
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Yanbin Zhu
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Hongyu Meng
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Zhucheng Jin
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Dandan Ye
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Wei Chen
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China.,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China
| | - Yingze Zhang
- Department of Orthopaedic surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, P. R. China. .,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China. .,Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, P. R. China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, P. R. China. .,Hebei Orthopedic Clinical Research Center, Shijiazhuang, 050051, Hebei, P. R. China.
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Lian X, Zhao K, Chen W, Zhang J, Li J, Meng H, Hou Z, Zhang Y. Application of a double reverse traction repositor in the retrograde intramedullary nailing of distal femur fractures. J Orthop Surg Res 2021; 16:168. [PMID: 33658059 PMCID: PMC7927219 DOI: 10.1186/s13018-021-02324-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/22/2021] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of this prospective study was to introduce the application of a double reverse traction repositor (DRTR) in the retrograde intramedullary nailing (RE-IMN) of AO/OTA 33A distal femur fractures. Patients and methods A total of 27 patients with AO/OTA type 33A distal femur fractures who were admitted from January 2015 to May 2017 to a level I trauma center of a tertiary university hospital were enrolled in this prospective study. A DRTR was used to facilitate RE-IMN for the reduction of distal femur fractures in all patients. The demographic and fracture characteristics, surgical data, postoperative complications, and prognostic indicators of 24 patients were recorded. Results The DRTR helped achieve and maintain the reduction of all distal femur fractures in the present study. All surgeries were conducted by closed reduction, and excellent alignment was observed in the postoperative X-ray images. In the present study, 18 males and 6 females were included, and the average age of all patients was 51.3 years (range, 24–68 years). The mean operation time, intraoperative blood loss, intraoperative fluoroscopy time, and length of postoperative hospital stay were 137 min (range from 80 to 210 min), 320 ml (range from 200 to 600 ml), 28 (from 24 to 33), and 9 days (from 5 to 14 days), respectively. Eleven patients were found to have postoperative deep venous thrombosis before discharge. No cases of wound infection were observed. No cases of nonunion or malunion were observed. The average follow-up duration was 21 months (18–30 months). The average HHS, LKFS, and VAS scores at the 1-year follow-up were 89.9 (86–97), 79.1 (75–87), and 2.1 (from 0 to 5). No complications associated with DRTR were found. Conclusions A DRTR can be successfully applied in the treatment of distal femur fractures with RE-IMN, and it can not only help achieve or maintain the reduction of distal femur fractures with closed methods but also promote fixation with RE-IMN.
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Affiliation(s)
- Xiaodong Lian
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Kuo Zhao
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Wei Chen
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Junzhe Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Junyong Li
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Hongyu Meng
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, PR China. .,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. .,Orthopaedic Research Institution of Hebei Province, Shijiazhuang, Hebei, 050051, PR China. .,NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China. .,Chinese Academy of Engineering, Beijing, 10088, P.R. China.
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Zhao K, Lian X, Tian S, Wang Z, Zhang J, Li J, Chen W, Hou Z, Zhang Y. Traction methods in the retrograde intramedullary nailing of femur shaft fractures: the double reverse traction repositor or manual traction. INTERNATIONAL ORTHOPAEDICS 2021; 45:2711-2718. [PMID: 33532898 DOI: 10.1007/s00264-021-04961-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The purpose of this prospective study was to compare the double reverse traction repositor (DRTR) and manual traction in retrograde intramedullary nailing (RE-IMN) for femoral shaft fractures. PATIENTS AND METHODS Seventy-seven patients with femur shaft fractures were randomized to undergo surgery with either DRTR or manual traction (MT) to facilitate RE-IMN between January 2018 and January 2019. Demographics, fracture characteristics, surgical data, post-operative complications, and functional outcomes were assessed. Data from 72 patients completing the final follow-up (12 months) were analysed in this study. RESULTS The average number of intra-operative perspectives in the DRTR group was 27.7, which was significantly reduced compared with that in the MT group (31.3, p < 0.001). Fewer assistants were required in the DRTR group compared with the MT group (1.1 vs 1.9, p < 0.001). Fewer patients with open reduction were discovered in the DRTR group compared with the MT group (2.8 vs 19.4, p=0.024). Demographics, fracture characteristics, other surgical data, and prognostic parameters were comparative between the two groups. CONCLUSIONS The DRTR can be effectively and safely used to treat femur shaft fractures with RE-IMN. The DRTR achieves similar results as MT and is also superior to MT in terms of intra-operative perspectives, the number of assistants, and the open reduction rate.
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Affiliation(s)
- Kuo Zhao
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Xiaodong Lian
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Siyu Tian
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhongzheng Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Junzhe Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Junyong Li
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Wei Chen
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
- Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.
- Orthopaedic Research Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.
- NHC Key Laboratory of Intelligent Orthopaedic Equipment, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
- Chinese Academy of Engineering, Beijing, 10088, People's Republic of China.
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